血管内超声在颈动脉狭窄支架成形术中的应用

目的 探讨血管内超声在颈动脉粥样硬化狭窄诊断和评价经皮血管内支架成形术治疗颈动脉狭窄的应用价值。方法 应用血管内超声，对8例经颈动脉B超初选疑诊颈动脉狭窄患者，进行颈动脉内壁病变判断，指导支架植入，并观察血管内支架植入前后血管形态学改变。结果 血管内超声清晰显示血管壁的形态结构，精确测量斑块面积、管腔面积和面积狭窄率。该组8例均接受内支架成形手术，成功置入支架8枚；经3～12个月的随访，除2例于术后30d内短暂性脑缺血(TIA)发作外，无其他病例TIA和脑梗塞再发生。结论 血管内超声应用于判断颈动脉狭窄和病变性质并引导经皮血管内支架成形术精确可靠，弥补了数字减影脑血管造影的不足。

Application of intravascular ultrasound in percutaneous intravascular stenting for carotid atherosclerosis

Objective To investigate the merits of intravascular ultrasound in the therapy of percutaneous intravas-cular stenting for carotid atherosclerosis. Methods Intravascular ultrasound was used to examine 8 patients with carotid artery stenosis pre-diagnosed by B-mode ultrasound; and direct stenting plantation and exploration of morphological changes of the carotid artery pre-stenting and post-stenting according to extent of pathological changes judged accurately by intravascular ultrasound (IVUS). Results Morphological configuration of the carotid artery could be revealed , and both the area of plaque and the lumen can be measured accurately. Eight patients who received angioplasty were successfully implanted with 8 stents without recurrence of TIA and stroke at a follow up period of 3 to 12 months. Conclusion IVUS can accurately estimate the extent of carotid artery stenosis and its pathological changes. IVUS is more sensitive in inspecting the plaques than arteriography which usually underestimates the severity of lesions.