摘要
目的总结联合应用近、远端保护装置经皮血管内支架治疗颈动脉重度狭窄的方法及经验。方法 2010年3-7月经造影确诊的颈动脉或颈内动脉颅外段重度狭窄患者5例,联合使用近端＋远端保护装置,经股动脉穿刺行颈动脉支架置入手术。结果除1例操作失败未能完成外,其余4例支架置入均获成功,术中未出现并发症,治疗效果满意。随访1~3个月,未出现脑缺血表现。结论对某些特殊颈动脉狭窄病变,在颈动脉支架置入术中联合应用近、远端保护装置,可弥补单一保护装置的不足,降低术中栓塞的风险,缩短术中血流中断时间,减少危险操作步骤,可作为颈动脉狭窄个体化治疗的选择。
Objective To analyze and summarize methods and experiences of combined application of distal and proximal embolic protection devices（EPD） in endovascular stenting for severe carotid artery stenosis.Methods Five patients with severe stenosis of the common carotid artery or with extracranial segment of the internal carotid artery diagnosed through digital subtraction angiography（DSA） from March to July 2010 were involved in the present study.All patients received carotid angioplasty and stenting（CAS）,with a combination of distal and proximal EPD via the percutaneous femoral artery approach.Results The operation failed in one patient,whereas technical success with no intraoperative complication was achieved in four patients.The symptoms disappeared or improved in the four cases that achieved technical success.The follow-up duration was one to three months,and no cerebral ischemia was found.Conclusion CAS with the combined application of distal and proximal EPD in some special cases of carotid artery stenosis may surmount the shortage of single EPD,reduce the risk of intraoperative embolization,decrease the time of intraoperative endovascular inflow occlusion,and reduce high-risk operations.CAS may be used as an individualized treatment strategy for patients with carotid artery stenosis.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2011年第9期939-941,共3页
Medical Journal of Chinese People's Liberation Army
关键词
颈动脉狭窄
支架
血栓栓塞
栓子保护装置
carotid stenosis
stents
thromboembolism
emboli-protected device
作者简介
[作者简介]杜志华，主治医师，硕士研究生。主要从事脑血管病的血管内介入工作
[通讯作者]李宝民，E-mail：baornin301@sohu．com
