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[评估症状性颈内动脉狭窄患者术后早期行颈动脉内膜切除术和颈动脉支架置入术的疗效及危险因素]

[Assessing efficacy and risk factors of carotid endarterectomy and carotid stenting in patients with symptomatic stenoses of internal carotid arteries in early postoperative period].

作者信息

Gavrilenko A V, Ivanov V A, Piven' A V, Kuklin A V, Antonov G I, Bobkov Iu A, Trunin I V, Abugov S A

出版信息

Angiol Sosud Khir. 2010;16(4):125-9.

Abstract

The present work was aimed at comparative assessment of efficacy and risk factors of carotid endarterectomy and carotid stenting in patients suffering from symptomatic stenoses of the internal carotid arteries, with due regard for the degree of the accompanying cardiac pathology, the presence of contralateral occlusion, and severity of chronic cerebrovascular insufficiency. We examined and treated a total of 142 patients diagnosed with stenoses of the internal carotid arteries and symptoms of chronic cerebrovascular insufficiency. In the cohort of those subjected to carotid endarterectomy we performed a total of 76 operations in 73 patients, and in the group of carotid stenting 71 operations of stenting of the internal carotid artery with cerebral protection in 69 patients. Postoperatively we assessed the following parameters: «stroke+lethality», incidence of transitory ischaemiс attacks, incidence rate of cerebrovascular neuropathy, and acute myocardial infarction. In the carotid endarterectomy group, we revealed increased risk for the development of neuropathy of the craniocerebral nerves (OR=0.0564, 95% CI 0.9953, P=0.049). In the group of stenting, we revealed increased risk for the development of transitory ischaemia.

摘要

本研究旨在对患有症状性颈内动脉狭窄的患者进行颈动脉内膜切除术和颈动脉支架置入术的疗效及风险因素进行比较评估,同时充分考虑伴随心脏疾病的程度、对侧闭塞的存在以及慢性脑血管供血不足的严重程度。我们共检查并治疗了142例被诊断为颈内动脉狭窄且有慢性脑血管供血不足症状的患者。在接受颈动脉内膜切除术的队列中,我们对73例患者共进行了76次手术;在颈动脉支架置入组中,对69例患者进行了71次有脑保护的颈内动脉支架置入手术。术后我们评估了以下参数:“卒中+致死率”、短暂性脑缺血发作的发生率、脑血管神经病变的发生率以及急性心肌梗死。在颈动脉内膜切除术组中,我们发现颅神经病变发生风险增加(OR=0.0564,95%CI 0.9953,P=0.049)。在支架置入组中,我们发现短暂性缺血发生风险增加。

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