脑梗死患者同侧颈动脉颅外段狭窄的血管内治疗-中华神经创伤.PDFVIP

·152· 中华神经创伤外科电子杂志2015年6月第 1卷第3期 ChinJNeurotraumaSurg(ElectronicEdition),June2015,Vol.1,No.3 ·临床研究· 脑梗死患者同侧颈动脉颅外段狭窄的 血管内治疗 1 1 2 1 1 丁晓东 孙鹏 张勇 赵彦 陈晓东 【摘要】 目的 探讨脑梗死患者颅外段颈动脉狭窄血管内支架治疗的安全性、中短期疗效和 适应证的掌握。 方法 回顾性分析2009 年1月至2014 年12月在青岛大学附属医院神经科收治 的行血管内支架治疗的颅外段颈动脉狭窄的病例，对其中106例既往有脑梗死患者的资料进行了 研究，分析其临床特点、治疗方法及预后。 结果 106例患者120个支架均置放满意。术后并发 脑出血3 例；支架内血栓形成2 例；低血压、心动过缓6 例；血管痉挛11例；消化道应激性出血1例； 再狭窄8 例，无脑梗死事件发生。除1例脑出血死亡、8 例再狭窄外，其余97 例患者中短期疗效满 意。对83 例患者随访3 月至5 年，未出现相关脑缺血症状或新发脑梗死。 结论 血管内治疗颈 动脉狭窄安全有效，适合既往存在脑梗死的患者；对此类患者应更慎重地个体化地评估手术风险， 严格掌握手术适应证；围手术期的综合处理措施是防治并发症的关键。 【关键词】 脑梗死； 颈动脉狭窄： 脑卒中； 支架； 血管内治疗 Endovascular treatment of cerebral infarction patients ipsilateral extracranial carotid artery 1 1 2 1 1 1 stenosis Ding Xiaodong , Sun Peng , Zhang Yong , Zhao Yan , Chen Xiaodong . Department of Neurosugery, 2Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao 266000, China Corresponding author: Zhao Yan, Email: 【Abstract 】 Objective To evaluate the safety, middle or short-term effect and indication of the endovascular treatment for ischemic stroke patients with extracranial carotid stenosis. Methods The clinical data of Affiliated Hospital of Qingdao University from June 2009 to December 2014 with percutaneous transluminal angioplasty and stenting for extracranial carotid artery stenosis cases were retrospectively reviewed ，from which 106 cases of ischemic stroke in the past were selected to study. And summarized the information including operation opportunity, operation experience, serious compli- cations such as cerebral hemorrhage and secondary ischemic stroke.Their clinical features ，method of treatments and prognosis were