Lago Aida, Aparici-Robles Fernando, Parkhutik Vera, Tembl José I, Mainar Esperanza, Vázquez-Añón Víctor, Claramonte Berta
Servicio de Neurología, Hospital Universitario La Fe, Valencia, Espana.
Rev Neurol. 2011 Nov 1;53(9):538-44.
Even today, unlike endarterectomy, long-term development in carotid angioplasty has still not been well defined. The aim of this study is to describe both the short- and long-term development and the rate of restenosis in a consecutive series of patients with carotid stenosis who underwent endovascular treatment at the Hospital Universitario La Fe; a distinction is made between patients with and without symptoms.
From 1999 to 2010, 426 patients were submitted to a carotid angioplasty (25.5% were asymptomatic patients). Clinical follow-ups were conducted in the case of 374 patients. They had annual check-ups and every year a neurosonological study was performed. The aim was to determine what complications occurred during the first 30 days, as well as the long-term complications, to establish the rate of restenosis and to evaluate possible differences between patients with and without symptoms.
The morbidity and mortality rate in the first month was 4.2% (4.4% in symptomatic patients and 3.8% in asymptomatic patients). The mean follow-up time was 55 months: 8% of patients presented strokes, 11% suffered from myocardial infarct and 24.3% died, with no significant differences between patients with or without symptoms. The rate of restenosis was 17.3% at five years, 7.5% equal to or above 50% and, of those, 1.1% were symptomatic. Five patients with significant restenosis were successfully treated with endovascular techniques.
Carotid angioplasty is an effective, safe technique in the hands of an experienced professional; our findings are good, both in the short and the long term, with a low rate of restenosis. If this latter condition occurs, vascular intervention techniques are safe and efficient.
即便在当今，与动脉内膜切除术不同，颈动脉血管成形术的长期发展仍未得到明确界定。本研究的目的是描述在拉费大学医院接受血管内治疗的一系列连续性颈动脉狭窄患者的短期和长期发展情况以及再狭窄率；对有症状和无症状患者进行区分。
1999年至2010年，426例患者接受了颈动脉血管成形术（25.5%为无症状患者）。对374例患者进行了临床随访。他们每年接受检查，并每年进行一次神经超声检查。目的是确定在最初30天内发生了哪些并发症以及长期并发症，确定再狭窄率，并评估有症状和无症状患者之间可能存在的差异。
第一个月的发病率和死亡率为4.2%（有症状患者为4.4%，无症状患者为3.8%）。平均随访时间为55个月：8%的患者发生中风，11%的患者发生心肌梗死，24.3%的患者死亡，有症状和无症状患者之间无显著差异。五年时再狭窄率为17.3%，50%及以上狭窄的发生率为7.5%，其中1.1%有症状。5例严重再狭窄患者通过血管内技术成功治疗。
在经验丰富的专业人员手中，颈动脉血管成形术是一种有效、安全的技术；我们的研究结果在短期和长期都很好，再狭窄率较低。如果发生后一种情况，血管介入技术是安全且有效的。
