| 127 | 15 | 20 |
| 下载次数 | 被引频次 | 阅读次数 |
目的评价脑保护装置下老年重度颈动脉狭窄患者颈动脉支架成形术的有效性及安全性。方法选择年龄≥70岁的重度症状性颈动脉狭窄患者43例,均行颈动脉支架成形术,术中均应用脑保护装置,观察术后狭窄改善情况,围术期并发症的发生情况以及回收的脑保护装置内脱落栓子情况,对患者随访1年。结果在43例患者中,脑保护装置及颈动脉支架均放置到位,术后残余狭窄率均<30%,患者颈动脉平均狭窄程度从(82.8±6.5)%降低至(12.4±5.9)%,支架置入手术前后比较,差异有统计学意义(P<0.05)。回收的脑保护装置中,发现27个有脱落的组织碎片,患者术后缺血相关症状均有明显改善,围术期所有患者均未出现症状性脑卒中,无手术相关死亡事件发生,1年随访无缺血性脑血管事件发生,颈动脉超声复查未见支架内发生再狭窄。结论脑保护装置下,对老年重度颈内动脉狭窄患者行颈动脉支架成形术安全、有效。
Abstract:[1]Kamenskiy AV,Pipinos II,Dzenis YA,et al.Effects of carotid artery stenting on arterial geometry.J Am Coll Surg,2013,217:251-262.
[2]Silver FL,Mackey A,Clark WM,et al.Safety of stenting and endarterectomy by symptomatic status in the Carotid Revascularization Endarterectomy Versus Stenting Trial(CREST).Stroke,2011,42:675-680.
[3]Alqadri SL,Qureshi AI.Treatment of symptomatic carotid stenosis:carotid stent placement versus endarterectomy.Curr Atheroscler Rep,2013,15:345.
[4]Perler BA.Outcomes of carotid endarterectomy and stenting in elderly patients.JAMA,2014,311:1244-1245.
[5]Bonati LH,Jongen LM,Haller S,et al.New ischaemic brain lesions on MRI after stenting or endarterectomy for symptomatic carotid stenosis:a substudy of the International Carotid Stenting Study(ICSS).Lancet Neurol,2010,9:353-362.
[6]Ansel GM,Hopkins LN,Jaff MR,et al.Safety and effectiveness of the INVATEC MO.MA proximal cerebral protection device during carotid artery stenting:Results from the ARMOUR pivotal trial.Catheter Cardiovasc Interv,2010,76:1-8.
[7]洪波,刘建民,许奕,等.过滤伞保护下的颈动脉狭窄支架成形术.中华放射学杂志,2004,38:45-47.
[8]刘高飞,李达文,朱敏,等.颈动脉支架置入术中颈动脉窦反应的原因分析及对策.中华老年心脑血管病杂志,2013,15:328-330.
[9]Carotid Stenting Trialists Collaboration,Bonati LH,Dobson J,et al.Short-term outcome after stenting versus endarterectomy for symptomatic carotid stenosis:apreplanned metaanalysis of individual patient data.Lancet,2010,376:1062-1073.
[10]Guimaraens L,Sola T,Vivas E,et al.Carotid recanalization in nonacute internal carotid artery occlusion:a therapeutic option for ischemic stroke.Clin Neurosurg,2012,59:119-125.
[11]Lieb M,Shah U,Hines GL.Cerebral hyperperfusion syndrome after carotid intervention:a review.Cardiol Rev,2012,20:84-89.
[12]郝强,李慎茂,焦力群,等.高危症状性颈动脉狭窄支架成形术的疗效分析.中国脑血管病杂志,2010,7:360-364.
[13]李生,黄承良,李宝民,等.颈动脉粥样硬化性狭窄患者支架置人术围手术期并发症的防治探讨.中华老年心脑血管病杂志,2010,12:892-894.
基本信息:
中图分类号:R743.3
引用信息:
[1]王承恩,孙成建,王彦华,等.颈动脉支架成形术治疗老年重度颈内动脉狭窄患者的疗效观察[J].中华老年心脑血管病杂志,2014,16(11):1209-1211.
2014-11-15
2014-11-15