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颈动脉狭窄血管内支架成形疗效分析 被引量：4

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摘要 目的分析总结神经内科19例经皮血管内支架治疗颈动脉狭窄的手术方法、适应症选择和并发症的预防。方法均经CTA或造影确诊,采用经股动脉入路,应用自膨式支架对颈动脉颅外段狭窄进行治疗。结果 19例手术18例获得成功,颈动脉狭窄得到有效改善,临床缺血症状术后得到明显改善,18例患者共置入颈动脉支架20枚、使用保护伞18个,其中2例患者分别于左右侧颈内动脉各植入1枚支架。回收的过滤伞中4个发现组织碎片。8例患者出现迷走反射均在球囊扩张及支架置入后,经对症处理全部缓解。6～30个月临床中短期随访12例,平均随访22个月。1例患者发生急性心肌梗死7d后死亡;1例患者出现小卒中;1例患者出现一过性脑缺血发作。随访12例支架全部开通良好,未出现再狭窄。随访6～30个月,未发现明显脑缺血发作,无B超发现支架内再狭窄病例。1例手术不成功。结论血管内支架成形治疗颅外段颈动脉狭窄是安全、有效的方法。
作者 吴章松 张均 陈生 金平
机构地区 安徽医科大学附属六安医院神经内科
出处 《中华全科医学》 2013年第5期732-733,共2页 Chinese Journal of General Practice
关键词 颈动脉狭窄 支架 血管内治疗
分类号 R543.4 [医药卫生—心血管疾病]
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参考文献8

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同被引文献40

  • 1何国厚,张晓东,刘开胜,罗国君.血管内支架成形术治疗颈动脉狭窄性短暂性脑缺血发作的疗效评价[J].卒中与神经疾病,2005,12(3):187-189. 被引量：18
  • 2Gensicke H,Zumbrunn T, Jongen LM,et al. Characteristics of Ischemic Brain Lesions After Stenting or Endarterectomy for Symptomatic Carotid Artery Stenosis Results From the International Carotid Stenting Study-Magnetic Resonance Imaging Substudy [J]. Stroke,2013,44(1):80-86.
  • 3Lal BK, Beach KW, Roubin GS, et al. Restenosis after carotid artery stenting and endarterectomy : a secondary analysis of CREST, a ran- domised controlled trial[J]. The Lancet Neurology,2012,11(9):755-763.
  • 4Rantner B,Goebel G,Bonati LH,et al. The risk of carotid artery stenting compared with carotid endarterectomy is greatest in patients treated within 7 days of symptoms [J]. Journal of vascular surgery,2013,57(3):619-626. e2.
  • 5Paraskevas KI, Abbott AL, Veith FJ. Optimal management of patients with symptomatic and asymptomatic carotid artery stenosis : work in progress[J]. Expert review of cardiovascular therapy,2014,12(4):437-441.
  • 6Montorsi P,Galli S,Ravagnani PM,et al. Carotid artery stenting in patients with left ICA stenosis and bovine aortic arch : a single-center experience in 60 consecutive patients treated via the right radial or brachial approach [J]. Journal of Endovascular Therapy,2014,21(1):127-136.
  • 7Naggara 0, Touz6 E,Beyssen B,et al. Anatomical and Technical Factors Associated With Stroke or Death During Carotid Angioplasty and Stenting Results From the Endarterectomy Versus Angioplasty in Patients With Symptomatic Severe Carotid Stenosis (EVA-3 S)Trial and Systematic Review[J]. Stroke,2011,42(2):380-388.
  • 8Brewster LP,Beaulieu R,Kasirajan K, et al. Contralateral occlusion is not a clinically important reason for choosing carotid artery stenting for patients with significant carotid artery stenosis[J]. Journal of vascular surgery,2012,56(5):1291-1295.
  • 9徐颖,钱维明,蒋丹青.颈内动脉内膜剥脱术1例的手术配合[J].护理与康复,2010,9(2):172-174. 被引量：2
  • 10骆荣江,李小敏,刘韶瑞,潘福顺,田臻.颈动脉狭窄致眼部缺血性疾病的诊疗分析[J].中华全科医学,2010,8(7):821-823. 被引量：11

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中华全科医学
2013年 第5期

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