介入放射学杂志
介入放射學雜誌
개입방사학잡지
Journal of Interventional Radiology
2015年
10期
910-913
,共4页
郭建明%李俊峰%谷涌泉%郭连瑞%俞恒锡%齐立行%崔世军%佟铸%高喜翔%吴英锋%刘梦霞%张建%汪忠镐
郭建明%李俊峰%穀湧泉%郭連瑞%俞恆錫%齊立行%崔世軍%佟鑄%高喜翔%吳英鋒%劉夢霞%張建%汪忠鎬
곽건명%리준봉%곡용천%곽련서%유항석%제립행%최세군%동주%고희상%오영봉%류몽하%장건%왕충호
颈动脉%无名动脉%狭窄%内膜剥脱术%支架植入术%复合手术
頸動脈%無名動脈%狹窄%內膜剝脫術%支架植入術%複閤手術
경동맥%무명동맥%협착%내막박탈술%지가식입술%복합수술
carotid%innominate artery%stenosis%endarterectomy%stent implantation%hybrid operation
目的：探讨颈动脉内膜剥脱术（CEA）联合颈动脉支架成形术（CAS）治疗颈动脉串联病变的安全性和有效性。方法回顾性分析2013年1月至2014年10月诊治的9例颈动脉串联病变患者资料,男7例,女2例,平均年龄（66.0±4.2）岁；病程2~36个月不等,平均7个月。所有患者均有脑缺血症状,5例存在短暂性脑缺血发作,既往脑梗死2例,伴有冠心病2例,高血压病6例,下肢缺血1例；于充分抗血小板治疗后接受CEA联合CAS术。结果手术技术成功率为100%,术后残余狭窄均小于30%,无围手术期死亡患者。9例患者术前症状均得到改善,无新发脑卒中、脑出血事件。术后2例出现头痛、头晕的脑灌注症状,但出院前均缓解。9例患者随访4~19个月,平均（10.5±6.2）个月,无症状复发,1例术后6个月复查经颅多普勒超声提示颈动脉中度（50%~70%）再狭窄,无死亡患者。结论 CEA联合CAS术治疗颈动脉串联病变是安全和有效的,但仍需更大样本远期随访研究进一步证实。
目的：探討頸動脈內膜剝脫術（CEA）聯閤頸動脈支架成形術（CAS）治療頸動脈串聯病變的安全性和有效性。方法迴顧性分析2013年1月至2014年10月診治的9例頸動脈串聯病變患者資料,男7例,女2例,平均年齡（66.0±4.2）歲；病程2~36箇月不等,平均7箇月。所有患者均有腦缺血癥狀,5例存在短暫性腦缺血髮作,既往腦梗死2例,伴有冠心病2例,高血壓病6例,下肢缺血1例；于充分抗血小闆治療後接受CEA聯閤CAS術。結果手術技術成功率為100%,術後殘餘狹窄均小于30%,無圍手術期死亡患者。9例患者術前癥狀均得到改善,無新髮腦卒中、腦齣血事件。術後2例齣現頭痛、頭暈的腦灌註癥狀,但齣院前均緩解。9例患者隨訪4~19箇月,平均（10.5±6.2）箇月,無癥狀複髮,1例術後6箇月複查經顱多普勒超聲提示頸動脈中度（50%~70%）再狹窄,無死亡患者。結論 CEA聯閤CAS術治療頸動脈串聯病變是安全和有效的,但仍需更大樣本遠期隨訪研究進一步證實。
목적：탐토경동맥내막박탈술（CEA）연합경동맥지가성형술（CAS）치료경동맥천련병변적안전성화유효성。방법회고성분석2013년1월지2014년10월진치적9례경동맥천련병변환자자료,남7례,녀2례,평균년령（66.0±4.2）세；병정2~36개월불등,평균7개월。소유환자균유뇌결혈증상,5례존재단잠성뇌결혈발작,기왕뇌경사2례,반유관심병2례,고혈압병6례,하지결혈1례；우충분항혈소판치료후접수CEA연합CAS술。결과수술기술성공솔위100%,술후잔여협착균소우30%,무위수술기사망환자。9례환자술전증상균득도개선,무신발뇌졸중、뇌출혈사건。술후2례출현두통、두훈적뇌관주증상,단출원전균완해。9례환자수방4~19개월,평균（10.5±6.2）개월,무증상복발,1례술후6개월복사경로다보륵초성제시경동맥중도（50%~70%）재협착,무사망환자。결론 CEA연합CAS술치료경동맥천련병변시안전화유효적,단잉수경대양본원기수방연구진일보증실。
Objective To investigate the safety and feasibility of carotid endarterectomy (CEA) combined with carotid artery stent angioplasty (CASA) in treating tandem stenosis of carotid artery. Methods The clinical data of 9 patients with tandem stenosis of carotid artery, who were treated at authors' hospital during the period from January 2013 to October 2014, were retrospectively analyzed. The patients included 7 males and 2 females, with a mean age of (66.0 ±4.2) years. The disease course ranged from 2 months to 36 months, with a mean of 7 months. Clinically, all patients had cerebral ischemia symptoms. Transient ischemia attack was seen in 5 patients and history of cerebral infarction was present in 2 patients. Coronary artery disease was found in 2 patients, hypertension in 6 patients and lower limb ischemia in one patient. After receiving adequate antiplatelet therapy, CEA and CASA were carried out in all patients. Results The technical success rate was 100%, postoperative residual stenosis was less than 30%, no death occurred in perioperative period. After the treatment, the clinical symptoms were improved in all 9 patients;no new stroke or cerebral hemorrhage occurred. After the treatment, 2 patients developed cerebral hyperperfusion-related symptoms such as headache and dizziness, which were much relieved at the time of discharge. The patients were followed up for 4-19 months, with a mean of (10.5±6.2) months. No recurrence of symptoms was observed . In one patient , transcranial Doppler ultrasound performed at 6 months after treatment showed that the carotid artery became moderate restenosis (50%-70%). No death occurred. Conclusion For the treatment of tandem stenosis of carotid artery, CEA combined with CASA is safe and effective, although larger sample and long-term follow-up studies are still needed to further confirm the effect.
