经桡动脉行颈动脉狭窄支架成形术的疗效分析

目的 探讨经桡动脉入路行颈动脉狭窄支架成形术的适应证和优势。方法 经桡动脉入路在颈内动脉岩部放置阻塞球囊，对38例颈动脉粥样硬化性狭窄患者行支架置人术。其中有症状者29例，无症状者9例。术前均行颈动脉数字减影血管造影（DSA）、脑实质血管DSA、颈动脉多普勒超声及头部MRI等检查。结果 术后患者均复查颈动脉DSA和脑实质血管DSA，显示脑部供血均有明显改善，其患侧颈内动脉、皮质下血管显影时问较术前提前0．3～0．8S，颅内血管血流经过时间缩短0．4～0．7s。短暂性脑缺血发作（TIA）症状消失。全组无手术死亡病例，无并发症。随访3～15个月，无再狭窄患者。结论 当经股动脉入路为相对禁忌时，经桡动脉入路是颈动脉狭窄支架成形术值得选择的一种入路。

The trans-radial approach for angioplasty and stenting on patients with atheromatous carotid stenosis

Objective To discuss the indications and the advantages of stenting for atheromatous carotid stenosis via trans-radial approach. Methods The angioplasties were performed while balloons were positioned in the carotid canal of the temporal bone by trans-radial approach in 38 cases with atheromatous carotid stenoses. Among them, 29 were symptomatic and 9 were asymptomatic. All patients were undergone preoperative cervical and cerebral DSA, Doppler uhrasonography and head MRI. Results Postoperative cervical and cerebral DSA showed that the cerebral blood supply was improved in all patients. The filling of cortical vessels 0.3 - 0. 8 s earlier than that before operation, while the circulation time of blood stream passing through cerebral vessels shortened 0.4 - 0.7 s compared to that before operation. There was no perioperative mortality and complications. Follow-up ranged from 5 to 16 months, showed no restenosis in all patients and no TIA occured. Conclusion Trans-radial approach for stenting of atheromatous carotid stenosis is an alternative and safe approach when trans-femoral approach is contraindicated.