症状性颈动脉狭窄伴有同侧中动脉狭窄的介入治疗效果研究

摘要/Abstract

摘要：

目的比较单纯颈动脉支架置入术治疗和联合颈动脉、大脑中动脉支架置入术治疗症状性颈动脉狭窄伴有中动脉狭窄的缺血性卒中或短暂性脑缺血发作（transient ischemic attack，TIA）患者短期终点事件发生率。方法回顾2010年1月～2013年12月采用血管内支架治疗症状性颈动脉狭窄伴有同侧大脑中动脉狭窄的缺血性卒中或TIA患者的临床资料。根据治疗情况将患者分为单纯颈动脉支架置入术治疗组和联合颈动脉、大脑中动脉支架置入术治疗组。比较两组术后90?d终点事件（包括同侧缺血性卒中复发、症状性脑出血及死亡风险）的发生率。结果共有21例患者纳入本研究，男性15例，女性6例，平均年龄（58.5±3.6）岁，其中16例患者进行了颈动脉支架治疗，5例患者进行了颈动脉联合中动脉支架治疗。颈动脉支架治疗组90?d终点事件发生3例（18.75%），颈动脉联合中动脉支架治疗组发生1例终点事件（20%），两组间差异无显著性（P=0.952）。两组发生的终点事件均为缺血性卒中复发，无症状性脑出血及死亡患者。结论对于伴有颈动脉及大脑中动脉狭窄的缺血性卒中或TIA患者，与单纯颈动脉支架治疗相比同时进行颈动脉及大脑中动脉支架治疗手术未减少术后90?d同侧缺血性卒中复发风险。

文章导读： 本研究通过回顾性分析显示对于伴有颈动脉及大脑中动脉狭窄的缺血性卒中/短暂性脑缺血发作患者，颈动脉联合大脑中动脉支架置入和单纯颈动脉支架相比，短期缺血性卒中复发率无明显差异。

关键词: 颈动脉狭窄; 颅内动脉狭窄; 支架

Abstract:

Objective To compare short end events of simple carotid artery stent implantation (CAS) and carotid artery, middle cerebral artery stent implantation (CAS+PTAS) treatment for symptomatic carotid stenosis accompanied by artery stenosis in ischemic stroke or transient ischemic attack (TIA) in patients. Methods We were retrospectively studied the TIA or ischemic stroke patients who had carotid artery stenosis and ipsilateral middle arterial stenosis. All patients were treated with stent implantation. Patients were divided into CAS group and CAS+PTAS group. The outcomes were compared between groups and the primary outcomes were ischemic stroke, symptomatic intracranial hemorrhage and all cause of death during 90 days of follow-up. Results A total of 21 patients included in this study with an average age of (58.5±3.6) years old and 15 cases were male. There were 16 patients in the CAS group and 5 patients in the CAS+PTAS group. There were 3 (18.75%) end points in CAS group and 1 end point in the CAS+PTAS group. There was no statistical difference between the two groups (P=0.952). There was no intracranial hemorrhage and all cause of death in both groups. Conclusion Compared with the CAS treatment, CAS+PTAS treatment does not reduce the recurrent ischemic stroke risk in patients with carotid artery stenosis and ipsilateral middle arterial stenosis.

Key words: Carotid stenosis; Intracranial artery stenosis; Stent

曹群，刘长喜，宋程光. 症状性颈动脉狭窄伴有同侧中动脉狭窄的介入治疗效果研究[J]. 中国卒中杂志, 2015, 10(07): 557-562.

CAO Qun, LIU Chang-Xi, SONG Cheng-Guang.. The Effect of Interventional Treatment in Patients with Symptomatic Carotid Artery Stenosis Associated with Ipsilateral Middle Arterial Stenosis [J]. Chinese Journal of Stroke, 2015, 10(07): 557-562.

参考文献

参考文献

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