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目的评价颈动脉支架植入安全性和有效性。方法前瞻性观察70位中国人所接受的76次颈动脉内膜旋切术 (CEA),对CAS的安全性及有效性做初步探讨。人选者均属高危患者,包括不稳定型心绞痛、同侧CEA史、对侧颈动脉狭窄、颈动脉放疗后狭窄及其他严重的合并症。患者于术前、术后及半年后随访时均接受独立的神经专科检查;于远期随访时复查脑血管造影。结果手术成功率为100％;术前平均狭窄程度达(82±18)％,术后狭窄程度下降至(5±10)％。所有患者共发生3次小卒中(5．7％),均无大卒中事件;住院期间及术后30 d内均无心肌梗死及死亡事件。平均随访期达 (20±12)月;2例患者发生无症状颈动脉再狭窄;2例患者发生非Q波型心肌梗死;两例患者因非神经源性因素死亡;3 例患者发生小卒中;远期随访未发现大卒中。结论在中国人群中,经皮颈动脉支架植入术是安全可行的,它的远期再狭窄率亦低。
Objective To evaluate the safety and effectiveness of carotid stenting. Methods A total of 76 carotid endarterectomy patients (CEA) accepted by 70 Chinese were prospectively observed. The safety and efficacy of CAS were investigated. Candidates are high-risk patients, including unstable angina, ipsilateral CEA history, contralateral carotid artery stenosis, carotid artery stenosis after radiotherapy and other serious complications. Patients underwent independent neurosurgical examinations before, during and after 6 months follow-up. Cerebral angiography was reviewed at long-term follow-up. Results The successful rate of operation was 100%. The mean preoperative stenosis was (82 ± 18)% and the degree of stenosis decreased to (5 ± 10)%. There were 3 minor strokes (5.7%) in all patients with no major stroke; no myocardial infarction and death occurred during hospitalization and within 30 days after surgery. The average follow-up period was (20 ± 12) months; 2 patients had asymptomatic carotid restenosis; 2 patients developed non-Q wave myocardial infarction; 2 patients died of non-neurogenic factors; 3 patients developed minor stroke Long-term follow-up found no major stroke. Conclusion Percutaneous carotid artery stenting is safe and feasible in Chinese population, and its long-term restenosis rate is also low.