CAJ | 학술논문

目的：评价脑保护装置下高龄重度颈动脉狭窄患者颈动脉支架成形术（CAS）的有效性及安全性。方法选择2009年1月—2012年1月在青岛大学医学院附属医院行 CAS 的高龄重度颈动脉狭窄患者37例，术中均应用脑保护装置，观察患者狭窄改善情况、围术期并发症发生情况、回收脑保护装置内脱落栓子情况，随访1年观察患者缺血性脑血管事件发生情况。结果36例患者脑保护伞均一次性顺利通过狭窄段放置到位成功释放；术后残余狭窄率均＜30％，平均狭窄程度从（83.0±6.7）％降至（13.0±6.1）％；回收的脑保护装置中有26个发现脱落的组织碎片；围术期均未出现脑出血、症状性脑梗死、支架内血栓形成等严重并发症；37例患者随访1年，无短暂性脑缺血发作（TIA）、卒中、死亡发生。结论脑保护装置下对高龄重度颈动脉狭窄患者行 CAS 成功率和安全性较高。
목적：평개뇌보호장치하고령중도경동맥협착환자경동맥지가성형술（CAS）적유효성급안전성。방법선택2009년1월—2012년1월재청도대학의학원부속의원행 CAS 적고령중도경동맥협착환자37례，술중균응용뇌보호장치，관찰환자협착개선정황、위술기병발증발생정황、회수뇌보호장치내탈락전자정황，수방1년관찰환자결혈성뇌혈관사건발생정황。결과36례환자뇌보호산균일차성순리통과협착단방치도위성공석방；술후잔여협착솔균＜30％，평균협착정도종（83.0±6.7）％강지（13.0±6.1）％；회수적뇌보호장치중유26개발현탈락적조직쇄편；위술기균미출현뇌출혈、증상성뇌경사、지가내혈전형성등엄중병발증；37례환자수방1년，무단잠성뇌결혈발작（TIA）、졸중、사망발생。결론뇌보호장치하대고령중도경동맥협착환자행 CAS 성공솔화안전성교고。
Objective To evaluate the efficacy and safety of carotid artery stenting assisted by cerebral embolic protec- tion devices in aged patients with severe carotid stenosis. Methods A total of 37 aged patients with severe carotid stenosis were selected in the Affiliated Hospital of Medical College,Qingdao University from January 2009 to January 2012,all of them under- went carotid artery stenting assisted by cerebral embolic protection devices. The improvement of carotid stenosis,incidence of complications during perioperative period,embolus in the embolic protection devices were observed;and incidence of ischemic cerebrovascular events during the one year fellow - up were recorded. Results Out of the 37 patients,36 patients successfully completed the carotid artery stenting,the remnant stenosis rate was less than 30% ,and the average degree of stenosis was (13. 0 ± 6. 1)% ,falled down from(83. 0 ± 6. 7)% ;26 cases found fragment of tissue in the embolic protection devices;no one occurred cerebral hemorrhage,symptomatic cerebral infarction or symptomatic cerebral infarction;no one occurred transient ischemic attack,stroke or death during the one year follow - up. Conclusion Carotid artery stenting assisted by cerebral embol- ic protection devices has high successful rate in aged patients with severe carotid stenosis,and high safety.