血管内支架成型术治疗颈动脉狭窄66例(1)
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2010年5月1日
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【摘要】目的:探讨血管内支架成型术治疗颈动脉狭窄的临床效果、安全性及并发症。方法:对经过颈部血管超声筛选有颈动脉狭窄的66例患者,进一步行脑血管造影,然后根据血管狭窄情况,选择合适球囊预扩后,将自膨式支架送至预想的位置释放,覆盖狭窄部位,66例患者共治疗69支血管。结果:治疗狭窄动脉69支,狭窄程度均明显改善,狭窄程度由原来的(88.96±11.7)%下降至(2.49±2.78)%,狭窄血管最大血流速度从(198.58±21.6)cm/s下降至(76.65±3.53)cm/s,术后患者症状均明显改善。无死亡病例,10例发生短暂性低血压及心率下降,28例发生持续性低血压及心率下降,1例术中出现同侧大脑中动脉急性闭塞事件,紧急溶栓、碎栓后血管开通,无任何后遗症。随访1～32个月,颈动脉超声检查治疗血管无再狭窄。结论:只要适应证选择正确,围术期处理得当,血管内支架成型术治疗颈动脉狭窄,不仅临床效果好,而且安全性高,无严重并发症。
【关键词】颈动脉狭窄;血管内支架成型术;脑缺血发作
doi:10.3969/j.issn.1006-1959.2010.05.102文章编号:1006-1959(2010)-05-1135-03
Carotid stenosis is being a common cause of ischemic stroke,because of the unsatisfactory therapeutic effect of drugs,Carotid endarterectomy (Carotid endaterectomy,CEA) is the effective method to reduce stroke in patient of carotid artery stenosis.With the advances in technology,materials by endovascular stent angioplasty had replaced the CEA[1-2],From July 2006 to December 2009 in our hospital, endovascular stent angioplasty treatment of carotid artery stenosis were using,69 stenotic vessels of 66 patients were treated using 69 stents,the clinical results are reported as follows.
1.MATERIALS AND METHODS
1.1 Materials:39 cases were males,27 cases were female among the 66 cases,the years old were 44 to 82.27 patients with transient ischemic attack.21 cases showed non-fluent speech and the side of the limb weakness,13 patients had recurrent dizziness performance,11 patients had a bad heavy headache,8 cases of personality had changed,taciturn,reaction retardation.11 cases showed recurrent episodes of blurred vision.66 cases of patients had been prompted by transcranial Doppler and showed the conditons of cerebral vascular insufficiency,the neck vascular color Doppler ultrasound had prompted and showed carotid artery stenosis in all patients.47cases had multiple patches,9 patients with ulcers,66 cases had hemodynamic abnormalities,stenosis peak systolic velocity were (198 ......
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