CAJ | 학술논문

颈动脉支架成形术治疗颈内动脉重度狭窄伴对侧颈动脉闭塞的疗效
경동맥지가성형술치료경내동맥중도협착반대측경동맥폐새적료효
Outcomes of carotid artery stenting for severe carotid stenosis in patients with contralateral occlusion

万方数据

中华普通外科杂志中華普通外科雜誌 중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2012年 7期 527-530 ,共4页

唐骁%郭大乔%符伟国%陈斌%蒋俊豪%徐欣%杨珏%史振宇%竺挺%董智慧%王利新%原野%王玉琦

당효%곽대교%부위국%진빈%장준호%서흔%양각%사진우%축정%동지혜%왕리신%원야%왕옥기

颈动脉狭窄%血管成形术%卒中%支架頸動脈狹窄%血管成形術%卒中%支架
경동맥협착%혈관성형술%졸중%지가
Carotid stenosis%Angioplasty%Stroke%Stents

目的评价脑保护下颈动脉支架成形术治疗一侧颈内动脉重度狭窄伴对侧颈动脉闭塞的疗效.方法回顾性分析38例患者的临床资料,包括围手术期30 d内及中远期并发症.结果即刻成功率为100％ (38/38).围手术期无死亡病例及缺血性脑卒中等严重并发症发生,总并发症发生率34.2％ (13/38),其中一过性脑缺血发作5.3％( 2/38).随访率86.8％ (33/38),平均随访时间(29±13)个月.随访期间死亡率0,总并发症发生率12.1％(4/33),其中再发一过性脑缺血发作6.1％ (2/33),无再发缺血性脑卒中病例.23例患者在手术前后行全脑CT灌注成像,结果显示术侧大脑半球灌注情况较术前改善.结论对于一侧颈内动脉重度狭窄伴对侧颈动脉闭塞的高危患者,脑保护下颈动脉支架成形术具有满意的围手术期结果和较好的远期脑卒中预防疗效.
목적 평개뇌보호하경동맥지가성형술치료일측경내동맥중도협착반대측경동맥폐새적료효.방법 회고성분석38례환자적림상자료,포괄위수술기30 d내급중원기병발증.결과 즉각성공솔위100％ (38/38).위수술기무사망병례급결혈성뇌졸중등엄중병발증발생,총병발증발생솔34.2％ (13/38),기중일과성뇌결혈발작5.3％( 2/38).수방솔86.8％ (33/38),평균수방시간(29±13)개월.수방기간사망솔0,총병발증발생솔12.1％(4/33),기중재발일과성뇌결혈발작6.1％ (2/33),무재발결혈성뇌졸중병례.23례환자재수술전후행전뇌CT관주성상,결과현시술측대뇌반구관주정황교술전개선.결론 대우일측경내동맥중도협착반대측경동맥폐새적고위환자,뇌보호하경동맥지가성형술구유만의적위수술기결과화교호적원기뇌졸중예방료효.
Objective To analyze the perioperative mortality,stroke rates and late benefits of carotid artery stenting for the treatment of unilateral severe stenosis of carotid artery with contralateral obliteration in a single medical center.Methods Clinical data of 38 cases were analyzed retrospectively,including postoperative period and follow-up.Results The technical success rate was 100％ ( 38/38 )with no peri-operative 30-day mortality or ischemic stroke.The overall peri-operative complication rate was 34.2％ ( 13/38),including transient ischemic attack (TIA) in 5.3％ (2/38).The average follow-up time was ( 29 ± 13 ) months with follow-up rate of 86.8％ ( 33/38 ).The mortality was 0 and the overall complication rate was 12.1％ (4/33),including TIA in 6.1％ (2/33).No patients had recurrent stroke.Twenty-three cases underwent whole brain CT perfusion evaluation before and after the therapy.A significant improvement of the perfusion parameters was observed in the stenotic side after CAS.Conclusions CAS contralateral to an occluded carotid artery can be performed with acceptable perioperative mortality and stroke risk rates,as well as a satisfactory long-term beneficial effect in stroke prevention.