Kaul U, Singh B, Bajaj R, Sapra R, Sudan D, Yadav R D, Garg R, Dixit N S
Department of Interventional Cardiology, Batra Hospital and Medical Research Centre, 1, Tughlakabad Institutional Area, Mehrauli Badarpur Road, New Delhi 110 062.
J Assoc Physicians India. 2000 Feb;48(2):196-200.
In symptomatic and asymptomatic patients with significant carotid artery stenosis, surgical endarterectomy has been shown to be beneficial when compared with medical management. Carotid stenting is evolving as an alternative technique for treating such patients. This prospective study was designed to assess the feasibility and safety of carotid angioplasty and stenting.
Fourteen patients (15 carotid arteries) with significant carotid artery stenosis were enrolled. These patients were in the age range 46 to 84 years (mean 60.9 +/- 7 years) and there were 12 males (86%). All of these patients were symptomatic with either TIA (n = 8) or stroke (n = 6). Wallstents were used in all the cases to stent the carotid arteries. One patient underwent bilateral carotid artery stenting.
Carotid angioplasty and stenting was successful in 13 out of 14 (92.8%) patients and 14 out of 15 (93.3%) carotid arteries, with reduction in mean (+/- SD) stenosis from 86 +/- 6% to 3 +/- 3%. There was one episode of minor stroke, no major stroke or death during the initial hospitalization. Another patient had a minor stroke with patent ipsilateral carotid artery (on repeat angiography) during the first 30 days after the procedure. This patient was also found to have asymptomatic thrombus formation in the contralateral carotid stent which resolved with intravenous anticoagulation. During a mean follow up of 6 +/- 2 months there has been no recurrence of symptoms.
Based upon our limited experience we believe that percutaneous carotid angioplasty with stenting is feasible with low periprocedural complication rate.
在有症状和无症状的严重颈动脉狭窄患者中，与药物治疗相比，外科内膜切除术已被证明是有益的。颈动脉支架置入术正在发展成为治疗此类患者的一种替代技术。本前瞻性研究旨在评估颈动脉血管成形术和支架置入术的可行性和安全性。
纳入14例（15条颈动脉）严重颈动脉狭窄患者。这些患者年龄在46至84岁之间（平均60.9±7岁），男性12例（86%）。所有这些患者均有症状，其中短暂性脑缺血发作（TIA）8例，中风6例。所有病例均使用Wallstents对颈动脉进行支架置入。1例患者接受了双侧颈动脉支架置入术。
14例患者中的13例（92.8%）和15条颈动脉中的14条（93.3%）颈动脉血管成形术和支架置入术成功，平均（±标准差）狭窄率从86±6%降至3±3%。初次住院期间有1次轻微中风发作，无重大中风或死亡。另1例患者在术后前30天内发生轻微中风，同侧颈动脉通畅（再次血管造影显示）。该患者还被发现对侧颈动脉支架内有无症状血栓形成，经静脉抗凝后血栓溶解。在平均6±2个月的随访期间，症状未复发。
基于我们有限经验，我们认为经皮颈动脉血管成形术加支架置入术是可行的，围手术期并发症发生率低。
