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症状性颈动脉动脉夹层支架置入术的可行性和安全性。

Feasibility and safety of stenting for symptomatic carotid arterial dissection.

机构信息

Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.

出版信息

Cerebrovasc Dis. 2011;32 Suppl 1:11-5. doi: 10.1159/000330315. Epub 2011 Jul 4.

Abstract

OBJECTIVE

To determine the procedural feasibility and safety of carotid angioplasty and stent placement of carotid artery dissection (CAD) patients who had failed antithrombotic therapy in acute dissection.

METHODS

A series of 33 consecutive patients (mean age, 40.21 years; 29 men and 4 women) who underwent angioplasty and stent placement for symptomatic carotid artery dissection (sCAD) from May 2005 to December 2010 in the Nanjing Stroke Registry Program (NSRP) was retrospectively reviewed. All the included patients had been diagnosed definitively based on catheter angiography, and had failed to respond to medical therapy during the course of initial hospital admission. The baseline and followed up data of these patients were collected and analyzed.

RESULTS

Of all the 33 included patients, 32 patients had achieved technical success without any intraoperative complications. Two patients manifested ipsilateral Horner sign on the next day after stenting, and one of them suffered from recurrence of transient ischaemic attack (TIA) during the course of follow up, but completely remission via antithrombotic therapy.

CONCLUSION

Endovascular stenting is a feasible and safe therapeutic strategy of CAD patients who have failed medical therapy.

摘要

目的

探讨对接受抗栓治疗但仍发生急性颈动脉夹层(carotid artery dissection,CAD)的症状性颈动脉夹层(symptomatic carotid artery dissection,sCAD)患者行颈动脉血管成形术和支架置入术的可行性和安全性。

方法

回顾性分析 2005 年 5 月至 2010 年 12 月南京卒中登记研究(Nanjing Stroke Registry Program,NSRP)中连续 33 例行血管成形术和支架置入术治疗 sCAD 的患者的临床资料。所有患者均经导管血管造影明确诊断,且在初始住院期间对初始治疗无反应。收集并分析患者的基线和随访资料。

结果

33 例患者中,32 例手术均获技术成功,无术中并发症发生。2 例患者术后第 2 天出现同侧霍纳综合征,其中 1 例患者在随访过程中复发短暂性脑缺血发作(transient ischemic attack,TIA),但经抗栓治疗完全缓解。

结论

对于接受抗栓治疗但仍发生 sCAD 的患者,血管内支架置入术是一种可行且安全的治疗策略。

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