Vozzi C R, Rodriguez A O, Paolantonio D, Smith J A, Wholey M H
Hemodinamia Rosario, Servicío de Hemodinamia, Hospital Español, Argentina.
Tex Heart Inst J. 1997;24(3):167-72.
Carotid percutaneous transluminal angioplasty, with or without stent implantation, is becoming another therapeutic option for carotid revascularization. To evaluate the feasibility and effectiveness of the technique, from October of 1995 to March of 1997, we performed 24 percutaneous transluminal angioplasty procedures in 22 patients with severe extracranial carotid artery stenosis. Three common carotid and 21 internal carotid arteries were treated, and 19 procedures included stent implantation using nonarticulated PALMAZ stents (P154 and P204). Twelve patients were asymptomatic and 10 patients were symptomatic; 2 of the symptomatic patients had complete obstruction of the internal carotid artery that was successfully recanalized. Technical and angiographic success was achieved in 23 of 24 procedures, with the carotid artery obstruction diminishing from 85.6% +/- 8.5% to 5.7% +/- 3.2% (P < 0.001). Average stenosis length was 12.5 +/- 3.1 mm, and mean time of carotid occlusion during balloon inflation was 11.5 +/- 2.5 seconds. Three patients experienced transitory seizures during the procedure prior to dilation, 1 patient had a minor stroke with complete recovery within 72 hours, and 1 patient had a major stroke and died 45 days after the procedure. Clinical follow-up was achieved in all patients (mean, 10.5 +/- 7.2 months) and angiographic follow-up in 16 patients (mean, 6.3 +/- 1.2 months). The results obtained in this initial experience provide adequate support to continue further evaluation of this new therapeutic strategy.
颈动脉经皮腔内血管成形术，无论是否植入支架，正成为颈动脉血运重建的另一种治疗选择。为评估该技术的可行性和有效性，我们于1995年10月至1997年3月期间，对22例严重颅外颈动脉狭窄患者实施了24例经皮腔内血管成形术。共治疗了3条颈总动脉和21条颈内动脉，其中19例手术使用了非关节式PALMAZ支架（P154和P204）进行支架植入。12例患者无症状，10例患者有症状；2例有症状患者的颈内动脉完全闭塞，成功实现再通。24例手术中有23例获得技术和血管造影成功，颈动脉阻塞率从85.6%±8.5%降至5.7%±3.2%（P<0.001）。平均狭窄长度为12.5±3.1mm，球囊扩张时颈动脉闭塞的平均时间为11.5±2.5秒。3例患者在扩张前手术过程中出现短暂性癫痫发作，1例患者发生轻度中风，72小时内完全恢复，1例患者发生严重中风，术后45天死亡。所有患者均获得临床随访（平均10.5±7.2个月），16例患者获得血管造影随访（平均6.3±1.2个月）。这一初步经验所获得的结果为继续进一步评估这一新的治疗策略提供了充分支持。
