Department of Radiology, University Hospital of South Manchester NHS Foundation Trust, Southmoor Road, Manchester, M23 9LT, UK.
Cardiovasc Intervent Radiol. 2011 Jun;34(3):488-92. doi: 10.1007/s00270-010-0006-9. Epub 2010 Nov 12.
Restenosis after carotid endarterectomy (CEA) has been described in 8-19% of patients, 14-23% of whom become symptomatic. This study analyzes our experience with carotid artery stenting (CAS) for post-CEA recurrent stenoses.
Retrospective database and case-note review.
Between January 2000 and September 2008, a total of 27 patients (15 symptomatic) with hemodynamically significant internal carotid artery post-CEA restenosis underwent CAS. Median stenosis of target vessels was 90% (range 75-95%). There was one periprocedural death (3.7%); no others occurred during the median 34-month follow-up (range 0.1-84 months). There was one late transient ischemic attack 12 months after CAS that was not associated with in-stent restenosis. One 90% restenosis and one occlusion were detected during follow-up at 38 and 57 months after CAS. The remaining patients had no evidence of further restenosis and remained free from cerebrovascular symptoms.
CAS offers a feasible option for the management of carefully selected patients with symptomatic and asymptomatic restenosis after CEA.
颈动脉内膜切除术 (CEA) 后的再狭窄在 8-19%的患者中被描述，其中 14-23%的患者出现症状。本研究分析了我们在颈动脉支架置入术 (CAS) 治疗 CEA 后复发性狭窄方面的经验。
回顾性数据库和病例记录回顾。
在 2000 年 1 月至 2008 年 9 月期间，共有 27 例（15 例有症状）患有血流动力学显著的颈内动脉 CEA 后再狭窄患者接受了 CAS 治疗。靶血管的狭窄中位数为 90%（范围 75-95%）。有 1 例围手术期死亡（3.7%）；在中位数为 34 个月的随访期间（范围 0.1-84 个月）没有发生其他死亡。有 1 例迟发性短暂性脑缺血发作发生在 CAS 后 12 个月，与支架内再狭窄无关。在 CAS 后 38 个月和 57 个月时，检测到 1 例 90%的再狭窄和 1 例闭塞。其余患者没有进一步再狭窄的证据，也没有脑血管症状。
CAS 为有症状和无症状 CEA 后再狭窄的精心选择的患者提供了一种可行的治疗选择。
