CAJ | 학술논문

目的：探讨彩色多普勒超声评价颈动脉支架置入术（carotid artery stenting ，CAS）和内膜剥脱术（carotid endarterecto-my ，CEA）后颈动脉再狭窄的价值。方法：经数字减影血管造影确诊53例患者共62支血管颈动脉狭窄，回顾分析患者CAS或CEA术前和术后的彩色多普勒超声结果，超声指标包括颈内动脉（internal carotid artery ，ICA）狭窄处血管内径、ICA和颈总动脉（common carotid artery ，CCA）狭窄处收缩期峰值流速（peak systolic velocity ，PSV）以及ICA舒张末期流速（end dias-tolic velocity ，EDV ）。结果：经治疗后，52支血管无明显再狭窄（狭窄率＜50％），病变血管内径较术前明显增宽（ P＜0．01）， PSVICA明显降低（P＜0．01）；10支血管出现≥50％的再狭窄，术后血管内径和PSVICA 较术前无明显变化（P＞0．05）；出现≥50％再狭窄血管的PSVICA、EDVICA及PSVICA/PSVCCA 较无明显狭窄血管明显增高（P＜0．01）。以 PSVICA/PS-VCCA≥2作为诊断标准，其预测术后再狭窄≥50％的敏感性和特异性分别为80．0％和98．1％。结论：彩色多普勒超声能够有效地评价CAS和CEA术后颈动脉再狭窄。
목적：탐토채색다보륵초성평개경동맥지가치입술（carotid artery stenting ，CAS）화내막박탈술（carotid endarterecto-my ，CEA）후경동맥재협착적개치。방법：경수자감영혈관조영학진53례환자공62지혈관경동맥협착，회고분석환자CAS혹CEA술전화술후적채색다보륵초성결과，초성지표포괄경내동맥（internal carotid artery ，ICA）협착처혈관내경、ICA화경총동맥（common carotid artery ，CCA）협착처수축기봉치류속（peak systolic velocity ，PSV）이급ICA서장말기류속（end dias-tolic velocity ，EDV ）。결과：경치료후，52지혈관무명현재협착（협착솔＜50％），병변혈관내경교술전명현증관（ P＜0．01）， PSVICA명현강저（P＜0．01）；10지혈관출현≥50％적재협착，술후혈관내경화PSVICA 교술전무명현변화（P＞0．05）；출현≥50％재협착혈관적PSVICA、EDVICA급PSVICA/PSVCCA 교무명현협착혈관명현증고（P＜0．01）。이 PSVICA/PS-VCCA≥2작위진단표준，기예측술후재협착≥50％적민감성화특이성분별위80．0％화98．1％。결론：채색다보륵초성능구유효지평개CAS화CEA술후경동맥재협착。
Objective:To investigate the value of color Doppler ultrasound in the evaluation of carotid artery restenosis after ca-rotid artery stenting (CAS) and carotid endarterectomy (CEA) .Methods :A total of 53 patients with 62 carotid artery stenosis diagnosed by digital subtraction angiography (DSA) were enrolled .All of them underwent CAS and CEA .The postoperative and preoperative ultrasound datum including the minimum luminal diameter ,the peak systolic velocity (PSV )of the internal ca-rotid artery (ICA) and common carotid artery (CCA) ,end diastolic velocity (EDV) of ICA were retrospectively analyzed . Results:A total of 52 arteries were normal or had <50% restenosis ,while 10 arteries had ≥50% restenosis after the treat-ment .Compared with those before treatment ,the minimum luminal diameter was significantly wider ,and PSVICA decreased significantly in patients with <50% restenosis(P<0 .01) ,whereas the minimum luminal diameter and PSVICA were not sig-nificantly changed in patients with≥50% restenosis(P>0 .05) .PSVICA ,EDVICA and PSVICA/PSVCCA in patients with≥50% restenosis significantly increased compared with that in patients with <50% restenosis(P<0 .01) .PSVICA/PSVCCA≥2 was set as the cut-off point ,the sensitivity and specificity for detecting ≥50% restenosis were 80 .0% and 98 .1% respective-ly .Conclusions :Color Doppler ultrasound can effectively evaluate carotid artery restenosis after CAS or CEA .