Li Sheng, Li Bao-min, Zhou Ding-biao, Wang Jun, Cao Xiang-yu, Liu Xin-feng, Ge Ai-li, Zhang A-lan
Department of Neurosurgery, General Hospital of Chinese People's Liberation Army, Beijing, China.
Zhonghua Wai Ke Za Zhi. 2011 Apr 1;49(4):303-6.
To discuss the efficiency and safety of carotid angioplasty stenting (CAS) in patients with contralateral carotid artery occlusion.
From January 2001 to January 2010, 56 carotid artery stenosis patients with contralateral carotid artery occlusion were performed CAS and the feature and results of these cases were analyzed retrospectively. All the cases were confirmed to be carotid artery stenosis with contralateral carotid artery occlusion by digital subtraction angiography (DSA). The diameter stenosis rate was 72% ± 15%. CAS were performed with distal protection device in 56 cases.
The technique success rate of CAS were 100% in all the 56 patients with contralateral carotid artery occlusion and post-procedure stenosis rate descended to 13% ± 8%, and the symptoms of cerebral ischemia were all improved. Only 1 case occurred remote hemorrhage in the position of previous cerebral infarction in the side of CAS after the procedure, and recovered with light neurological deficit after the craniotomy to remove the hematoma. No ischemic complications or death occurred. During the following up of 6 months to 3 years, no cerebral ischemic symptoms reoccurred. The rechecking results of color Doppler of 47 cases and DSA of 2 cases showed no restenosis in-stent.
CAS is safe and effective for the patients with contralateral carotid artery occlusion. Critical election of the case, operation of skilled doctors and scrupulous post procedure general management can decrease the rate of complication.
探讨对侧颈动脉闭塞患者行颈动脉血管成形术支架置入术（CAS）的有效性和安全性。
回顾性分析2001年1月至2010年1月期间56例对侧颈动脉闭塞的颈动脉狭窄患者行CAS的特点及结果。所有病例均经数字减影血管造影（DSA）证实为对侧颈动脉闭塞的颈动脉狭窄。直径狭窄率为72%±15%。56例均使用远端保护装置行CAS。
56例对侧颈动脉闭塞患者CAS技术成功率均为100%，术后狭窄率降至13%±8%，脑缺血症状均改善。术后仅1例在CAS侧既往脑梗死部位发生远期出血，开颅清除血肿后遗留轻度神经功能缺损并恢复。无缺血性并发症及死亡发生。随访6个月至3年，无脑缺血症状复发。47例彩色多普勒复查及2例DSA复查结果显示支架内无再狭窄。
CAS治疗对侧颈动脉闭塞患者安全有效。严格筛选病例、术者操作熟练及术后细致的综合管理可降低并发症发生率。
