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总结血管内支架治疗颈动脉粥样硬化性狭窄的临床体会 ,探讨该技术的适应证、并发症防治及初步疗效。材料和方法 :55例颈动脉狭窄患者(2000年10月至2001年12月 ,40例有反复的短暂性脑缺血发作或脑梗死 ,1例小脑出血 ,14例无明显症状)在球囊扩张后安装自膨胀血管内支架 ,其中33例还应用不可脱卸球囊进行支架内再扩张。结果 :53例支架定位准确 ,2例释放支架时支架向近端移位。31例患者狭窄完全消失 ,20例狭窄程度减少90 %以上 ,4例减少70 % ,术中1例发生短暂脑缺血性发作 ,1例发生脑梗死。临床随访1～15个月(平均6.1个月) ,仅1例术后2个月发作TIA1次。颈动脉超声随访42例 ,DSA随访15例患者颈动脉均无再狭窄发生(6～12月)。结论 :血管内支架成形术是治疗颈动脉狭窄的安全而有效方法 ,长期疗效有待于进一步观察
To summarize the clinical experience of endovascular stenting in the treatment of carotid atherosclerotic stenosis, and to explore the indications, complications prevention and initial curative effect of this technique. Materials and Methods: 55 patients with carotid stenosis (October 2000 to December 2001, 40 cases of recurrent transient ischemic attack or cerebral infarction, 1 case of cerebellar hemorrhage, 14 cases without obvious symptoms) in the balloon After expansion, self-inflating vascular stents were installed, of which 33 cases were also re-expandable using a non-removable balloon. Results: 53 cases were accurately positioned and 2 cases were displaced proximally when the stent was released. The stenosis disappeared completely in 31 patients, the stenosis in 20 patients was reduced by 90% or more, and the reduction in 4 patients was 70%. One patient had transient ischemic attack and one patient had cerebral infarction. Clinical follow-up 1 to 15 months (average 6.1 months), only 1 case 2 months after the onset of TIA1 times. Forty-two patients were followed up for carotid ultrasonography. No carotid restenosis occurred in 15 patients (6-12 months) after DSA. Conclusion: Endovascular stenting is a safe and effective method for the treatment of carotid artery stenosis. Long-term curative effect needs to be further observed