摘要
目的探讨颈动脉狭窄患者行支架植入术的安全性及近、远期疗效。方法回顾性分析2005年1月至2010年12月在沈阳军区总医院住院的48例颈动脉狭窄患者,在远端脑保护装置下植入颈动脉支架,观察其围术期并发症及临床疗效。结果48例颈动脉狭窄患者,年龄(66±6.8)岁,男41例(85.4%,41/48),靶病变1处/例,病变长度(22.5±10.3)mm,狭窄程度88.5%±9.9%。手术成功率100%,植入颈动脉自膨式支架1枚/例,使用远端滤网保护装置1个/例,支架直径(7.3±2.4)mm,长度(36.0±5.5)mm,术后即刻残余狭窄程度5.6%±4.5%。术中11例(22.9%,11/48)出现心率减慢,于术中给予1 mg阿托品静脉注射,心率恢复至正常范围。2例(4.2%,2/48)出现一侧肢体活动障碍,经治疗24 h后好转,术后无严重并发症发生。随访(36.2±15.5)个月,随访率93.8%(45/48),2例(4.4%,2/48)患者死亡,其中1例死于肺癌,1例死于缺血性脑卒中,4例(8.9%,4/48)患者仍有头晕发作,3例(6.7%,3/48)偶有肢体麻木,无严重脑缺血发作,无脑梗死、脑出血发生。术后6～12个月复查增强计算机断层扫描:无颈动脉、椎动脉及肾动脉支架内再狭窄。结论在远端脑保护装置下行颈动脉支架植入术是治疗颈动脉狭窄安全有效的手段,手术成功率高,长期临床随访患者仍能从中获益。
Objectives To determine the safety and long-term efficacy of stent implantation in patients with carotid artery stenosis. Methods Totally 48 patients with angiography confirmed carotid artery stenosis hospitalized in General Hospital of Shenyang Military Region from January 2005 to December 2010 were recruited. All stents were implanted into carotid artery with guidance of distal cerebral protection devices in order to observe perioperative complications and clinical efficacy. Results The mean age of all 48 patients were （66.0±6.8） years, 41 patients （85.4%, 41/48） were male. There was one target lesion per patient. The stenotic lesions were averagely （22.5±10.3） mm in length and 88.5%±9.9% in degree of stenosis. The procedural success rate was 100%. Each lesion underwent 1 self-expanding stent implantation with guidance of a distal cerebral protection device. The stent was averagely （7.3±2.4） mm in diameter and （36.0±5.5） mm in length. The degree of immediate postprocedural residual stenosis was 5.6%±4.5%. During the procedure, 11 patients （22.9%, 11/48） presented dropped heart rate, which was restored to normal after administration of 1 mg atropine; 2 patients （4.2%, 2/48） arouse unilateral limb movement, which was recovered within 24 hours after treatment. No serious postprocedural complications were found. The average follow-up duration was （36.2-＋15.5） months, and the follow-up rate was 93.8% （45/48）. A total of 2 patients （4.4%, 2/48） died, including 1 case of lung cancer and 1 of ischemic stroke. Still 4 patients （8.9%, 4/48） were attacked by dizziness and 3 patients （6.7% ,3/48） had occasional numbness in limbs. There was no severe cerebral ischemic attack, cerebral infarction or cerebral hemorrhage. From 6 to 12 months＇ follow-up results after operation, enhanced computed tomography （CT） scans showed no in-stent restenosis in carotid. Conclusions With guidance of distal cerebral protection devices, carotid artery stenting show
出处
《岭南心血管病杂志》
2013年第3期266-268,共3页
South China Journal of Cardiovascular Diseases
关键词
颈动脉狭窄
颈动脉支架植入术
外周动脉造影术
carotid artery stenosis
carotid stent implantation
peripheral angiography
