颈动脉支架成形术治疗重度颈动脉狭窄25例效果分析
发布时间：2018-07-27 15:52
【摘要】：目的评价颈动脉支架成形术(CAS)治疗重度颈动脉狭窄患者手术特点、安全性和围手术期处理。方法 2011年12月至2016年5月采用CAS术治疗25例颈动脉狭窄85%患者,术中针对病变狭窄特点应用远端脑保护装置,注重个体化手术细节和围术期处理方案,观察血运重建、脑保护装置内脱落栓子情况,控制并发症发生。术后随访1年观察患者缺血性脑血管事件发生情况。结果 25例患者脑保护装置均通过重度狭窄后成功释放,球囊预扩张、支架释放后形态满意。北美症状性颈动脉内膜剥脱术试验研究(NASCET)方法检测显示,平均颈动脉狭窄程度由术前(91.0±3.1)%降至术后(21.0±5.1)%,保护伞均顺利回收,其中6个伞中发现脱落组织碎片。围术期未出现症状性脑出血、脑梗死、氋灌注综合征、死亡等严重事件。25例患者随访1年,无短暂性脑缺血发作、脑卒中、死亡发生。结论 CAS术治疗重度颈动脉狭窄患者时需注意术中个体化细节管理及围术期处理,选择合适的脑保护装置,以确保手术成功率和安全性。部分重度狭窄患者的术后疗效更直观而迅速。
[Abstract]:Objective to evaluate the surgical characteristics, safety and perioperative management of (CAS) for severe carotid stenosis. Methods from December 2011 to May 2016, 25 patients with carotid artery stenosis were treated with CAS. According to the characteristics of stenosis, the distal cerebral protective device was used during the operation. The details of individual operation and perioperative management were paid attention to, and the revascularization was observed. The occurrence of complications was controlled by abscission of embolus in cerebral protective device. Patients were followed up for 1 year to observe the occurrence of ischemic cerebrovascular events. Results the protective devices of 25 patients were successfully released after severe stenosis, balloon predilation and satisfactory shape after stent release. The (NASCET) method showed that the mean degree of carotid stenosis decreased from (91.0 卤3.1)% before operation to (21.0 卤5.1) after operation, and the protective umbrella was recovered successfully. Among them, shards of tissue were found in 6 umbrellas. There were no symptomatic cerebral hemorrhage, cerebral infarction, perfusion syndrome, death and other serious events in the perioperative period. 25 patients were followed up for one year. There was no transient ischemic attack, stroke and death. Conclusion the individualized detail management and perioperative management should be paid attention to in the treatment of severe carotid artery stenosis by CAS, and appropriate cerebral protective devices should be selected to ensure the success rate and safety of the operation. The postoperative effect of partial severe stenosis is more direct and rapid.
【作者单位】： 解放军第85医院神经内科;
【分类号】：R651.1
[Abstract]:Objective to evaluate the surgical characteristics, safety and perioperative management of (CAS) for severe carotid stenosis. Methods from December 2011 to May 2016, 25 patients with carotid artery stenosis were treated with CAS. According to the characteristics of stenosis, the distal cerebral protective device was used during the operation. The details of individual operation and perioperative management were paid attention to, and the revascularization was observed. The occurrence of complications was controlled by abscission of embolus in cerebral protective device. Patients were followed up for 1 year to observe the occurrence of ischemic cerebrovascular events. Results the protective devices of 25 patients were successfully released after severe stenosis, balloon predilation and satisfactory shape after stent release. The (NASCET) method showed that the mean degree of carotid stenosis decreased from (91.0 卤3.1)% before operation to (21.0 卤5.1) after operation, and the protective umbrella was recovered successfully. Among them, shards of tissue were found in 6 umbrellas. There were no symptomatic cerebral hemorrhage, cerebral infarction, perfusion syndrome, death and other serious events in the perioperative period. 25 patients were followed up for one year. There was no transient ischemic attack, stroke and death. Conclusion the individualized detail management and perioperative management should be paid attention to in the treatment of severe carotid artery stenosis by CAS, and appropriate cerebral protective devices should be selected to ensure the success rate and safety of the operation. The postoperative effect of partial severe stenosis is more direct and rapid.
【作者单位】： 解放军第85医院神经内科;
【分类号】：R651.1
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