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目的评价介入颈动脉血管内支架置入术和内科药物治疗双侧重度颈动脉狭窄患者的效果,观察干预后再发脑卒中的中短期随访结果。方法21例双侧重度颈动脉狭窄患者,按随机数字表分成两组:A组8例患者接受颈动脉血管内支架置入术治疗,B组13例患者接受内科药物治疗;1年半后分别随访临床和超声波检查。结果A组8例手术患者支架放置成功,术前颈动脉狭窄程度为70%～98%,术后狭窄程度小于10%,除1例偶发1次短暂性脑缺血发作(TIA)外,其他患者未出现脑血管病发作;B组9例(9/13)患者再次发生脑卒中(其中4例患者出现TIA发作,2例死亡),另4例(4/13)患者病情无变化,超声波检查发现7例(7/11)患者颈动脉内中膜增厚、动脉粥样斑块增多增大,管腔进一步狭窄。结论颈动脉狭窄血管内支架置入术中短期疗效优于内科药物治疗。
Objective To evaluate the effect of interventional carotid artery stenting and internal medicine on patients with severe bilateral carotid artery stenosis and to observe the short-term follow-up results of stroke after intervention. Methods Twenty-one patients with bilateral severe carotid artery stenosis were divided into two groups according to a random number table: 8 patients in group A received carotid artery stenting and 13 patients in group B received medical treatment. One and a half years later, Follow-up clinical and ultrasound examination. Results A total of 8 cases of surgical patients in Group A were placed successfully. The preoperative carotid stenosis was 70% -98% and the degree of stenosis was less than 10%. Except for 1 case of transient ischemic attack (TIA) There was no episode of cerebrovascular disease in 9 patients (9/13) in group B (4 patients had TIA attack and 2 patients died), and the other 4 patients (4/13) had no change in disease. Ultrasound Examination found that 7 cases (7/11) patients with carotid intima-media thickening, atherosclerotic plaque increased, the lumen further narrowed. Conclusion The short-term curative effect of endovascular stenting of carotid artery stenosis is better than that of medical treatment.