在一家三级医疗中心对接受或未接受远端保护装置的颈动脉支架置入术后患者进行长期随访。
Long-term follow-up of patients after carotid stenting with or without distal protective device in a single tertiary medical center.
作者信息
Kimiagar Itzhak, Gur Alexander Y, Auriel Eitan, Peer Amir, Sacagiu Tzvika, Bass Arie
机构信息
Department of Neurology, Assaf Harofeh Medical Center, Zerifin, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.
出版信息
Vasc Endovascular Surg. 2012 Oct;46(7):536-41. doi: 10.1177/1538574412457471. Epub 2012 Aug 17.
OBJECTIVE
To evaluate the immediate and long-term clinical outcomes after carotid artery stenting (CAS) with and without protection devices (PDs), compared with carotid endarterectomy (CEA).
METHODS
A total of 116 patients with symptomatic carotid stenosis underwent CAS; 56 patients (48.3%) underwent CAS-PD; and 137 patients underwent CEA.
RESULTS
There were more ipsilateral transient ischemic attacks (TIAs) in the CEA group than in CAS-PD and CAS + PD (4 [3%] vs 1 [1.6%] and 0 respectively, P = 0.02). In the CAS-PD group there were more vertebrobasilar TIAs, ipsi- and contralateral strokes, myocardial infarctions, and death rates in the 30-day postprocedural period. After 8-year follow-up, there were 18 (30%) death cases in the CAS-PD group, 10 death cases (17%) in the CAS + PD patients, and 15 death cases (11%) in the CEA group of patients (P = .02).
CONCLUSION
Our data show that CAS + PD was associated with lower rate of vascular complications and mortality compared with CAS-PD and CEA.
目的
评估使用和不使用保护装置（PD）的颈动脉支架置入术（CAS）与颈动脉内膜切除术（CEA）相比的近期和长期临床结果。
方法
共有116例有症状的颈动脉狭窄患者接受了CAS；56例患者（48.3%）接受了带保护装置的CAS（CAS-PD）；137例患者接受了CEA。
结果
CEA组同侧短暂性脑缺血发作（TIA）比CAS-PD组和带保护装置的CAS（CAS+PD）组更多（分别为4例[3%]对1例[1.6%]和0例，P=0.02）。在CAS-PD组中，术后30天内椎基底动脉TIA、同侧和对侧中风、心肌梗死及死亡率更多。8年随访后，CAS-PD组有18例（30%）死亡病例，CAS+PD组有10例（17%）死亡病例，CEA组有15例（11%）死亡病例（P=0.02）。
结论
我们的数据表明，与CAS-PD和CEA相比，CAS+PD与更低的血管并发症发生率和死亡率相关。
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