Rath P C, Lakshmi G, Agarwala Manoj, Kumar Sunil, Rao P S, Henry Michel
Apollo Heart Institute, Hyderabad.
Indian Heart J. 2003 May-Jun;55(3):241-4.
Neurologic events associated with distal embolization of debris during percutaneous carotid artery stenting complicate the procedure. Filter devices for cerebral protection potentially reduce the risk of embolization and other neurologic events. We studied the feasibility, safety, and efficacy of carotid artery stenting with a filter device.
Between January 2002 and January 2003, a total of 22 consecutive patients (30 lesions) who had >70% diameter stenosis of the internal carotid artery underwent carotid artery stenting with filter protection at our institute. The mean age of the patients was 64+/-9 years; 14 were men and 8 women, and 15 had neurologic symptoms. A stent was successfully implanted in 29 lesions. It was possible to position a filter device in all the 29 lesions. Neurologic complications during the procedure, in the hospital, and at 30-day clinical follow-up occurred in 2 patients. One patient suffered a minor stroke that resolved within 24 hours. None of the patients had a major embolic stroke. There was one death from intracerebral hemorrhage related to hyperperfusion and the use of a glycoprotein IIb/IIIa inhibitor.
Filter protection during carotid artery stenting seems technically feasible, safe, and effective. In the present study, the incidence of embolic neurologic events was low.
经皮颈动脉支架置入术中与碎片远端栓塞相关的神经事件使手术复杂化。脑保护滤器装置有可能降低栓塞及其他神经事件的风险。我们研究了使用滤器装置进行颈动脉支架置入术的可行性、安全性和有效性。
在2002年1月至2003年1月期间，我们研究所共有22例连续患者（30处病变），其颈内动脉直径狭窄>70%，接受了带滤器保护的颈动脉支架置入术。患者的平均年龄为64±9岁；男性14例，女性8例，15例有神经症状。29处病变成功植入了支架。所有29处病变均成功置入滤器装置。2例患者在手术期间、住院期间及30天临床随访时出现神经并发症。1例患者发生轻微卒中，在24小时内恢复。无患者发生重大栓塞性卒中。有1例患者因与过度灌注及使用糖蛋白IIb/IIIa抑制剂相关的脑出血死亡。
颈动脉支架置入术中的滤器保护在技术上似乎可行、安全且有效。在本研究中，栓塞性神经事件的发生率较低。
