CAJ | 학술논문

目的评估颈动脉支架术治疗颈动脉狭窄合并冠心病患者的可行性和安全性.方法入选2005年1月至2010年6月在阜外心血管病医院接受颈动脉支架术的237例颈动脉狭窄合并冠心病患者,对其临床资料进行回顾性分析.颈动脉支架术的指征为颈动脉管腔直径减少＞60％(症状性颈动脉狭窄)或＞80％(无症状性颈动脉狭窄),且颈动脉解剖适合行支架术.观察支架术后30 d卒中、死亡和心肌梗死的发生情况.结果患者年龄(66.1±7.7)岁,男性189例(79.7％).不稳定性心绞痛87例(36.7％),近期(＜30 d)心肌梗死82例(34.6％).颈动脉支架术的技术成功率为99.2％(235/237),栓塞防护装置的使用率为99.6％(234/235).36例(15.2％)患者同时行双侧颈动脉支架术,79例(33.3％)患者同时行其他外周动脉的介入治疗.颈动脉支架术后30 d,127例(53.6％)患者进行了冠状动脉血运重建,包括118例(49.8％)冠状动脉旁路移植术,9例(3.8％)冠状动脉支架术.支架术后30 d,大卒中、小卒中、死亡和心肌梗死的发生率分别为2.1％(5/237)、3.0％(7/237)、0.4％(1/237)和0.4％(1/237).结论颈动脉狭窄合并冠心病患者行颈动脉支架术安全、可行,围手术期并发症发生率低.
목적 평고경동맥지가술치료경동맥협착합병관심병환자적가행성화안전성.방법 입선2005년1월지2010년6월재부외심혈관병의원접수경동맥지가술적237례경동맥협착합병관심병환자,대기림상자료진행회고성분석.경동맥지가술적지정위경동맥관강직경감소＞60％(증상성경동맥협착)혹＞80％(무증상성경동맥협착),차경동맥해부괄합행지가술.관찰지가술후30 d졸중、사망화심기경사적발생정황.결과 환자년령(66.1±7.7)세,남성189례(79.7％).불은정성심교통87례(36.7％),근기(＜30 d)심기경사82례(34.6％).경동맥지가술적기술성공솔위99.2％(235/237),전새방호장치적사용솔위99.6％(234/235).36례(15.2％)환자동시행쌍측경동맥지가술,79례(33.3％)환자동시행기타외주동맥적개입치료.경동맥지가술후30 d,127례(53.6％)환자진행료관상동맥혈운중건,포괄118례(49.8％)관상동맥방로이식술,9례(3.8％)관상동맥지가술.지가술후30 d,대졸중、소졸중、사망화심기경사적발생솔분별위2.1％(5/237)、3.0％(7/237)、0.4％(1/237)화0.4％(1/237).결론 경동맥협착합병관심병환자행경동맥지가술안전、가행,위수술기병발증발생솔저.
Objective To evaluate the safety and feasibility of carotid artery stenting (CAS) for treating patients with coexisting carotid and coronary artery disease.Methods The clinical data of 237 consecutive patients [(66.1 ± 7.7) years old,79.7％ male] with coexisting carotid and coronary artery disease undergoing CAS in Fuwai hospital from January 2005 to June 2010.The patients were analyzed retrospectively.Indication for CAS was defined as carotid artery diameter reduction of ＞ 60％ (symptomatic) or ＞ 80％ (asymptomatic) with suitable carotid artery anatomy for stenting.Thirty-day rates of stroke,death and myocardial infarction after CAS were assessed.Results All patients suffered from coronary artery disease,of whom 87 (36.7％) had unstable angina pectoris and 82 (34.6％) had recent myocardial infarction (＜ 30 days).The procedural success rate of CAS was 99.2 ％ (235/237).Cerebral protection devices were used in 234 patients (99.6％).Among them,36 (15.2％) patients received simultaneous bilateral CAS and 79 (33.3％) patients underwent simultaneous percutaneous intervention of other noncoronary arteries.Within 30 days after CAS,127 (53.6％) patients underwent coronary revascularization,including 118 (49.6％) coronary artery bypass grafting and 9 (3.8％) percutaneous coronary intervention.The rate of major stroke,minor stroke,death and myocardial infarction from time of CAS to 30 days was 2.1％ (5/237),3.0％ (7/237),0.4％ (1/237) and 0.4％ (1/237) respectively.Conclusion Data from this study indicate that CAS is safe and feasible for treating patients with coexisting carotid and coronary artery disease with a low incidence of periprocedural complication rate.