CAJ | 학술논문

目的：探讨颈动脉支架置入成形术（ CAS ）术前影像学评估，为该手术提供有力的循证支持。方法回顾并分析2002年3月至2010年12月完成的110例颈动脉支架成形术的术前风险评估、手术方法、围手术期并发症和术后随访结果，达到非常满意的效果，对有特征的病例总结出其影像学上的特点。结果根据影像结果提出了五种最能支持颈动脉支架置入术的证据：症状性颈动脉高度狭窄（75％以上），Willis环未能建立的病例；颅内虽无梗死灶，但狭窄斑块不稳定、特别是溃疡性斑块的病例；病变血管虽有部分被代偿，但仍明显低灌注，且相应供血区已形成腔隙性梗死灶的病例；病变血管为“双重责任”血管的病例；串联病变或“双侧病变血管”。结论对症状性高度狭窄的颈动脉采用支架成形术进行治疗，方法简单、相对安全、近期及远期效果满意，是安全、有效的治疗方法，术前充分的影像学评估，为该技术提供可靠的技术保障。
목적：탐토경동맥지가치입성형술（ CAS ）술전영상학평고，위해수술제공유력적순증지지。방법회고병분석2002년3월지2010년12월완성적110례경동맥지가성형술적술전풍험평고、수술방법、위수술기병발증화술후수방결과，체도비상만의적효과，대유특정적병례총결출기영상학상적특점。결과근거영상결과제출료오충최능지지경동맥지가치입술적증거：증상성경동맥고도협착（75％이상），Willis배미능건립적병례；로내수무경사조，단협착반괴불은정、특별시궤양성반괴적병례；병변혈관수유부분피대상，단잉명현저관주，차상응공혈구이형성강극성경사조적병례；병변혈관위“쌍중책임”혈관적병례；천련병변혹“쌍측병변혈관”。결론대증상성고도협착적경동맥채용지가성형술진행치료，방법간단、상대안전、근기급원기효과만의，시안전、유효적치료방법，술전충분적영상학평고，위해기술제공가고적기술보장。
Objective To explore the imaging evaluation of the carotid angioplasty stenting ( CAS ) , to provide powerful evidence for such operation .Methods Reviewed and analysed the risk-benefit before stenting , technique,complication during peroperative period and the follow-up visit results of postoperation of 110 cases, which completed the CAS successly ,summarize the imaging characteristics .Results Proposed five powerful evidences to support the CAS according to the imaging results:the case that was symptomatic carotid artery highly stenosis ( above 75%) , but intracranial arteries circle not established;the case that was not any intracranial infarcts ,but the plaques in the stenosis was instable , especially the ulcerative plaques; Although some vascular lesions were compensated partly,there was still obviously low infusion and lacunar infarctions in the corresponding blood -supply area;The case that was vascular lesions for "double responsibility "; The case that was series lesions of the vascular or “bilateral vascular lesions”.Conclusion Adopted endovascular stents formation operation to treat symptomatic carotidment can have safty and good effect , furthermore the technology is simple .The imaging evaluation before the operation can support the technical reliable .