颈动脉支架置入术患者的神经并发症
Neurologic complications in patients with carotid artery stenting.
作者信息
Kim Na Young, Choi Jong Wook, Whang Kum, Cho Sung Min, Koo Youn Moo, Kim Jong Yeon
机构信息
Department of Neurosurgery, Yonsei University Wonju College of Medicine, Wonju Severance Christian Hospital, Wonju, Korea.
出版信息
J Cerebrovasc Endovasc Neurosurg. 2019 Jun;21(2):86-93. doi: 10.7461/jcen.2019.21.2.86. Epub 2019 Jun 30.
OBJECTIVE
Carotid artery stenting is helpful in patients with carotid artery stenosis and is a common method of treatment. However, data on the neurological consequences that might arise from, especially Asian patients after CAS is not enough. The purpose of this study was to investigate the outcome and prognostic factors affecting CAS patients.
METHODS
From January 2013 to June 2018 it was enrolled 97 patients who underwent CAS with severe carotid artery stenosis in a single institution. We retrospectively reviewed neurologic complications such as restenosis, ipsilateral or contralateral stroke, and hyperperfusion during the 6-month follow-up period.
RESULTS
There were no complication occured during the procedure in all 97 patients. Neurologic complications occurred in 30 patients (30.9%) after the procedure, and ipsilateral stroke 6 (6.2%), contralateral stroke 9 (9.4%), restenosis 2 (2.1%) and hyperperfusion 13 respectively. One of them had died (1.0%), of which the rest were discharged after symptoms improve. On univariate analysis, DM and pre-op NIHSS score was associated with the risk of CAS complication, exclusively. On the binary logistic regression for risk factors, DM (OR 0.144, 95% CI [0.029-0.718]), history of radiotheraphy (OR 36.103, 95% CI [1.009-1291.789]) and preoperative NIHSS (OR 1.266, 95% CI [1.059-1.513]) showed independent risk factors associated with post procedural neurological complications, statistically.
CONCLUSION
Carotid artery stenting is a relatively safe and reliable long-term outcome for patients with carotid artery stenosis. However, careful observation should be taken after procedure immediately for any possible complications.
目的
颈动脉支架置入术对颈动脉狭窄患者有益,是一种常见的治疗方法。然而,关于尤其是亚洲患者在颈动脉支架置入术后可能出现的神经学后果的数据并不充分。本研究的目的是调查颈动脉支架置入术患者的结局及影响预后的因素。
方法
2013年1月至2018年6月,在一家机构纳入了97例行颈动脉支架置入术治疗严重颈动脉狭窄的患者。我们回顾性分析了6个月随访期内的神经并发症,如再狭窄、同侧或对侧卒中以及高灌注。
结果
97例患者术中均未出现并发症。术后30例患者(30.9%)出现神经并发症,其中同侧卒中6例(6.2%)、对侧卒中9例(9.4%)、再狭窄2例(2.1%)、高灌注13例。其中1例死亡(1.0%),其余患者症状改善后出院。单因素分析显示,仅糖尿病和术前美国国立卫生研究院卒中量表(NIHSS)评分与颈动脉支架置入术并发症风险相关。在危险因素的二元逻辑回归分析中,糖尿病(比值比[OR]0.144,95%置信区间[CI][0.029 - 0.718])、放疗史(OR 36.103,95%CI[1.009 - 1291.789])和术前NIHSS(OR 1.266,95%CI[1.059 - 1.513])在统计学上显示为与术后神经并发症相关的独立危险因素。
结论
对于颈动脉狭窄患者,颈动脉支架置入术是一种相对安全可靠的长期治疗方法。然而,术后应立即密切观察是否有任何可能的并发症。