颈内动脉狭窄支架颈动脉狭窄支架.docVIP

血管内支架治疗颈内动脉狭窄203例 来源：广东医学杂志?点击数： 201?更新时间：2007-4-25?文章录入：Admin ????血管内支架治疗颈内动脉狭窄203例????李慎茂??缪中荣??朱凤水??王默力???华扬???董岩???宋庆斌??凌锋????首都医科大学宣武医院神经外科(北京 100053)????【摘要】目的探讨颈内动脉狭窄的血管内支架治疗方法及手术方法。方法选择颈内动脉狭窄大于85%的患者203例，围手术期进行抗凝治疗，全部行全脑血管造影及颈部超声检查。采用两类4种不同支架，分预扩与不预扩两种操作。结果203例操作顺利，无临床并发症，影像学评价完全成功，超声波检查脑血流恢复正常或好转；86例临床症状消失；57例临床症状不同程度好转。3～24个月随访脑血管造影及超声波复查支架形态良好，血流通畅，血管无再狭窄。结论颈内动脉狭窄的血管内支架治疗是安全的，支架的选择与是否预扩尚待商榷。????【关键词】颈动脉狭窄???支架???介入治疗??? Percutaneous transluminal stenting for 203 stenosis of internal carotid arteryLi Shenmao, Miao Zhongrong, Zhu Fengshui， et al.? Department of Neurosurgery, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053????【Abstract】ObjectiveTo evaluate the methodology of percutaneous transluminal stenting for stenosis of internal carotid artery（ICA）. Methods203 patients of ICA stenosis greater than 85% were included. All cases were under anticoagulative therapy perioperatively and underwent cerebral vascular angiography and cervical Doppler sonography. Four kinds of different stents were used with or without advance angioplasty. ResultsAll of? 203 cases underwent operation smoothly without any complications. All? cases were successful on image post procedure. CBF was found to be normal or? increased on sonography. Symptoms disappeared in 86 cases and improved for? various degrees in 57 cases. On angiographic and sonographic followup for 3 to 24 months, no distortion of stents and restenosis was found and blood flow was patent. ConclusionPercutaneous transluminal stenting is a safe therapeutic method for stenosis of internal carotid artery with appropriate perioperative therapy and operative method. Selection of stents and application of advance angioplasty? warrants further investigation.????【Key words】Stenosis of internal carotid arteryStentsInterventional radiology颈内动脉狭窄的血管内支架治疗在操作中可能出现严重的并发症［1～4］，阻碍着这项技术的发展与推广。我们通过对203例颈内动脉高度狭窄病例的血管内支架治疗的总结研究，旨在提出一套操作方法，供研究探讨。??? 1资料与方法11一般资料收集我院1998年2月至2002年8月颈内动脉狭窄大于85%，行血管内支架的患者203