颈动脉颅外段狭窄支架成形术后抗动脉硬化效果的随访研究_谈晓牧.pdfVIP

颈动脉颅外段狭窄支架成形术后抗动脉硬化效果的随访研究 谈晓牧,耿晓坤, 朱浩猛,魏建朝,杜会山(, 101100 ) []　:探讨颈动脉颅外段狭窄行经皮血管内成 及支架置入术 (PTAS)后抗动脉硬化的远期效果。:39 例颈动 脉颅外段狭窄均采用自膨式支架经股动脉入路行 PTAS, 治疗过程中均使用保护伞, 术后在抗血小板聚集治疗基础上长期应用 阿托伐他汀及普罗布考,观察临床症状改善情况及 PTAS术后再狭窄情况。:患者术前平均血管狭窄率为 82.02%, 术后 残余狭窄率为 10.13%,较术前明显下降, 其中24例脑梗死治疗前神经功能缺损评分为 6.38 ±3.16, 治疗后为 5.42 ±2.78, 治 疗前后比较差异有统计学意义(P0.01);治疗前认知功能评分为 21.79 ±3.05, 治疗后为 22.63 ±2.57, 差异亦有统计学意义 (P0.01);15例短暂性脑缺血发作 (TIA)未再发作。平均随访 2 1 个月, 再发脑供血不足 3例, TIA2例, 脑梗死 1例;6例均 存在治疗依从性差、危险因素控制不理想情况, 其余患者治疗依从性好, 无卒中症状再发, 经颅多普勒超声检查示支架部位血 管通畅良好, 未出现血管再狭窄。:PTAS是治疗颈动脉颅外段狭窄微创、有效的方法, 术中使用保护伞可提高治疗的安全 性, 术后联合应用抗血小板聚集药物及阿托伐他汀、普罗布考可能降低远期再狭窄率, 提高治疗效果。 []　颈动脉狭窄;支架;血小板聚集抑制剂;随访研究 []　R54 3.5　　　[]　A　　　　[]　1002-34 29 (2009 )10-0007 -03 EffectofAnti-ateioscleosisFollowingofPecutaneousTansluminalAngioplastyandStenting(PTAS)ofExtacanial SegmentStenosisofCaotidAtey:aFllow-upReseachStudy TANXiao-mu, GENGXiao-kun, ZHUHao-men,gWEIJian-cha,oDUHui-shan(LuheHospita,lTongzhouDistic,tBeijing 101100, China) [Abstac]t　Objective:ToexploethetheapyofPTASofextacanialsegmentstenosisofcaotidateyandthelong-tem effectivenessofant-iateioscleosisafteopeation.Method:s39 patientswithextacanialsegmentstenosisofcaotidateyundewent PTASwithself-expandstentandpotectiveumbellabytheappoachoffemoalatey.Allthepatientsundewenttheapyofantiplatelet du,gatovastatinandpobucolafteopeation.Result:sThemeanstenosisateofpatientswas82.02% pe-opeatio,nand10.13% post-opeationwithanobviousdecease.Thescoesofneuologicmipaimentandcognitivefunctionof24 stokepatientsweeimpoved: 6.38 ±3.16, 5.42 ±2.78, postopeationwithstatisticaldiffeence(P0.01 )and21.79 ±3.05, 22.63 ±2.57, postopeationwith statisticaldiffeence(P0.01)andtheTAIin15 stokepatientsweecontolled.Themeanfollow-uppeiodwas21 month.sWithinthe peio,dtheewee6 patientswithecuenceofceebalischemicsymptome(3 weeceebovasculainsufficiencysyndom,e2 weeTIA and1 wasceebalinfaction).Afteanalysi,swefoundthatpatientshadpootheapycomplianceandtheiskfactohadnotbeen contolledeffective