CAJ | 학술논문

目的评价颈动脉支架植入安全性和有效性.方法前瞻性观察70位中国人所接受的76次颈动脉内膜旋切术(CEA),对CAS的安全性及有效性做初步探讨.入选者均属高危患者,包括不稳定型心绞痛、同侧CEA史、对侧颈动脉狭窄、颈动脉放疗后狭窄及其他严重的合并症.患者于术前、术后及半年后随访时均接受独立的神经专科检查;于远期随访时复查脑血管造影.结果手术成功率为100%;术前平均狭窄程度达(82±18)%,术后狭窄程度下降至(5±10)%.所有患者共发生3次小卒中(5.7%),均无大卒中事件;住院期间及术后30 d内均无心肌梗死及死亡事件.平均随访期达(20±12)月;2例患者发生无症状颈动脉再狭窄;2例患者发生非Q波型心肌梗死;两例患者因非神经源性因素死亡;3例患者发生小卒中;远期随访未发现大卒中.结论在中国人群中,经皮颈动脉支架植入术是安全可行的,它的远期再狭窄率亦低.
목적평개경동맥지가식입안전성화유효성.방법전첨성관찰70위중국인소접수적76차경동맥내막선절술(CEA),대CAS적안전성급유효성주초보탐토.입선자균속고위환자,포괄불은정형심교통、동측CEA사、대측경동맥협착、경동맥방료후협착급기타엄중적합병증.환자우술전、술후급반년후수방시균접수독립적신경전과검사;우원기수방시복사뇌혈관조영.결과수술성공솔위100%;술전평균협착정도체(82±18)%,술후협착정도하강지(5±10)%.소유환자공발생3차소졸중(5.7%),균무대졸중사건;주원기간급술후30 d내균무심기경사급사망사건.평균수방기체(20±12)월;2례환자발생무증상경동맥재협착;2례환자발생비Q파형심기경사;량례환자인비신경원성인소사망;3례환자발생소졸중;원기수방미발현대졸중.결론재중국인군중,경피경동맥지가식입술시안전가행적,타적원기재협착솔역저.
Objective To evaluate the safety and efficacy of carotid artery stenting (CAS). Methods We prospectively evaluated the safety and efficacy of 76 carotid artery stenting (CAS) procedures in a consecutive series of 70 Chinese patients. This series represented a high-risk group that included patients with unstable angina, previous ipsilateral CEA, contralateral carotid artery occlusion, post-radiation carotid artery stenosis and other severe co-morbid conditions. The patients had independent neurological examinations before and after the procedure and follow-up cerebral angiography at 6 month. Results The procedural success rate was 100%. The mean carotid artery stenosis was (82± 18)% before and (5± 10)% after the procedure. During the initial hospital period and 30 days after CAS, there was no major stroke but 3 minor strokes (5.7%). No myocardial infarctions or deaths occurred during or within 30 days following CAS. At a mean follow-up of 20±12 months, 2 patients (2.8%) had asymptomatic restenosis, and 2 non-Q wave myocardial infarction. Death occurred in 2 cases, but none of them was attributed to a neurological cause. Three patients had minor strokes and no major strokes occurred during the follow-up period.Conclusion Percutaneous carotid artery stenting is feasible for performance in Chinese patients and may lower the restenosis rate.