颈动脉狭窄支架植入术后血管生物重构与血流动力.docVIP

脑内颈动脉狭窄支架植入术后血管重构特点与血流动力学的改变 孟昕1 刘建林1 杜亚娟2 1西安交通大学医学院第一附属医院干5病区 陕西 西安 710061 2西安交通大学医学院第一附属医院 周围血管科超声室 陕西 西安 710061 摘要：目的：探讨脑内颈动脉狭窄支架植入术后血管重构与血流动力学的改变情况，力求发现支架内再狭窄的发生机制，为临床治疗提供更好的生理学参考。方法：40例颈动脉狭窄脑疾病患者采用支架植入术后，应用高频彩色多普勒超声观察术后血管重构与血流动力学的改变情况。结果：40例患者分为软斑块5例，混合斑块25例，钙化斑块10例。相对于术前，支架的近心端、中间段、远心端内径在术后3天内、1个月、3个月持续增加(PO.01)。PSVIGA、EDAICA、PSVIGA/PSVCCA在术后持续增快(PO.01)，但是过了1月后开始有所下降。PSVCCA在术后各个时间点都没有明显变化(PO.01)。术后1月的搏动指数(PI)和阻力指数(RI)明显下降，以后趋向平稳(PO.01)。结论：颈动脉支架植入术改变了血管的重构特点与血流动力学情况，可能对血管修复有重要影响，值得继续深入研究。 关键词：颈动脉狭窄支架植入术；血管重构；血流动力学；彩色多普勒超声 The analysis of characteristic of vascular remodeling and changes of hemodynamics after carotid stenting in brain Meng Xin1 Liu Jianlin 1 Du Yajuan2 1 Xian Jiaotong University School of Medicine, First Affiliated Hospital, Xian 710061 2 Medical School of Xian Jiaotong University First Affiliated Hospital of peripheral vascular ultrasound room Xian 710061 Abstract: Objective: To investigate the changes of vascular remodeling and hemodynamics after carotid stenting and to attempt to identify in-stent restenosis stent system for providing better physiological clinical information. Methods: 40 patients with carotid artery stenosis patients and cerebrovascular disease were treated by the carotid stenting， used the color doppler ultrasound for observe the changes of vascular remodeling and hemodynamics.Results: There were 5 cases of soft plaque， 25 cases of mixed plaque， 10 cases of calcified plaque in the 40 patients. The proximal， middle and distal diameter after 3 days， 1 month， 3 months carotid stenting were continue increased (P 0.01). Tbe PSVIGA、EDAICA、PSVIGA/PSVCCA were persistent postoperative increased (P 0.01)， but had declined after 1 month. The PSVCCA had not significantly changed (P 0.01)at each time point. And after 1 month ， the pulsatility index (PI) and resistance index (RI) decreased significantly.Conclusion: The carotid artery stenting can change vascular remodeling and hemodynamic characteristics, it may have