Bathala Lokesh, Zhu Fenglei, Ma Minmin, Ma Yuping, Xu Gelin, Liu Xinfeng
Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Ann Indian Acad Neurol. 2010 Jul;13(3):188-91. doi: 10.4103/0972-2327.70883.
To evaluate the results of carotid artery angioplasty and stenting (CAS) in treating extracranial carotid artery stenosis performed by neurologists in our center and compare the results with other large published series.
Data for all patients who underwent CAS from January 2003 through November 2007, was retrieved from the Nanjing Stroke Registry. Perioperative and post-procedural complications within 30 days following stenting were analyzed and compared with that from other series. A total number of 75 patients were enrolled, with a mean age of 65.9 ± 8.8 years, and 64 (85.3%) of them were male.
Procedural success was achieved in 74 patients (98.7%). Pre-treatment stenosis was 73.8 ± 14.9 and post-treatment residual stenosis was less than 10%. Thirty-four patients (45.3%) had bilateral carotid artery disease and seven (9.3%) had tandem stenosis. The neurological complication rate was 3.9% (one major and two minor strokes). Bradycardia in four (5.3%) and hypotension in 13 (17.3%) were observed during procedures. Using the Fischer's exact t test, the complication rate compared with the large published series did not reveal any statistically significant difference (P > 0.05).
We conclude that neurologists, with adequate training, can develop and add this technical skill to the existing cognitive skill of vascular neurology and safely perform stenting.
评估我院神经科医生进行的颈动脉血管成形术和支架置入术(CAS)治疗颅外颈动脉狭窄的效果,并与其他已发表的大型系列研究结果进行比较。
从南京卒中登记处检索2003年1月至2007年11月期间所有接受CAS治疗患者的数据。分析支架置入术后30天内的围手术期和术后并发症,并与其他系列研究进行比较。共纳入75例患者,平均年龄65.9±8.8岁,其中64例(85.3%)为男性。
74例患者(98.7%)手术成功。术前狭窄率为73.8±14.9,术后残余狭窄率小于10%。34例患者(45.3%)患有双侧颈动脉疾病,7例(9.3%)患有串联狭窄。神经并发症发生率为3.9%(1例严重卒中,2例轻度卒中)。术中观察到4例(5.3%)出现心动过缓,13例(17.3%)出现低血压。使用Fisher精确t检验,与其他已发表的大型系列研究相比,并发症发生率无统计学显著差异(P>0.05)。
我们得出结论,经过充分培训的神经科医生可以掌握并将这项技术技能融入现有的血管神经病学认知技能中,并安全地进行支架置入术。