阜外医院研究称,支架治疗严重颈外动脉狭窄合并同侧颈内动脉闭塞效果好

2018-01-26 许菁 中国循环杂志

阜外医院蒋雄京等研究提示,颈外动脉支架术治疗可改善并存同侧严重颈外动脉狭窄和颈内动脉闭塞患者的脑缺血和认知功能,且1年随访并发症发生率低。

阜外医院蒋雄京等研究提示,颈外动脉支架术治疗可改善并存同侧严重颈外动脉狭窄和颈内动脉闭塞患者的脑缺血和认知功能,且1年随访并发症发生率低。

研究共包括17例患者,平均年龄65.4岁。颈外动脉支架术的技术成功率为100%。

2 例患者在围手术期发生血流动力学抑制,经对症治疗2天内完全恢复。

研究者提醒,提前预防和及时处理血流动力学抑制可保证手术顺利进行,提高患者的舒适度。

研究者采取的做法是:(1)术前适当减少β 受体阻滞剂或非二氢吡啶类钙拮抗剂用量。(2)对位于颈动脉分叉附近的病变,球囊预扩张或支架置入前预防性应用阿托品。(3)术中快速静脉补液。

12 个月随访时,1 例患者发生对侧小卒中,其余16 例患者未再出现脑缺血症状

围手术期和12个月随访未见其他并发症的发生。

与术前比较,术后3个月时患者的简易智能量表评分和蒙特利尔认知量表评分均升高,并且两个量表评分在12 个月的随访过程中持续升高。

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