颈动脉支架置入术后支架内血栓形成研究进展

doi:10.3969/j.issn.1673-5765.2019.06.020

摘要/Abstract

摘要：

颈动脉支架内血栓形成是颈动脉支架置入术后的严重并发症，可导致患者严重瘫痪甚至死亡。然而迄今为止，针对颈动脉支架内血栓形成，仍没有统一的治疗方式。虽然有很多病例报道了颈动脉支架内血栓形成的处理方法，但是仍缺少随机双盲试验或大型临床试验来证实其可靠性、安全性。在临床上，与手术操作相关的颈动脉支架内血栓形成，是颈动脉支架内血栓形成的最主要原因。除此之外，抗血小板治疗不充分或停止抗血小板治疗、高凝状态、抗血小板药物抵抗也可导致颈动脉支架内血栓形成。目前，抗血小板及抗凝治疗、溶栓治疗、颈动脉内膜剥脱术及颈动脉支架术、机械取栓或血栓抽吸治疗等均有报道，无论何种治疗方式，使患者快速获得血管再通是颈动脉支架内血栓形成治疗的关键。

文章导读： 本文对颈动脉支架内血栓形成的流行病学及病因、发病时间、治疗手段及预后进行阐述，为临床上颈动脉支架内血栓形成的诊疗提供参考。

关键词: 颈动脉支架置入术; 支架内血栓形成; 围手术期

Abstract:

In-stent thrombosis is a serious complication after carotid artery stenting (CAS), which may lead to severe paralysis and even death. However, till now, there is still no uniform treatment for in-stent thrombosis. Although cases reports have showed various therapy methods for in-stent thrombosis after CAS, there is still no randomized double-blind trial or large clinical trial to confirm the reliability and safety of these intervention measures. The main cause of instent thrombosis after CAS is related to surgical operation, the other causes include inadequate antiplatelet therapy or discontinuation of antiplatelet therapy, hypercoagulable state, and platelet drug resistance and etc. The treatment for in-stent thrombosis after CAS include antiplatelet and anticoagulant therapy, thrombolytic therapy, carotid endarterectomy and CAS, mechanical thrombectomy or thrombus aspiration and etc. Either way, rapid vascular recanalization is the key of treatment for in-stent thrombosis .

Key words: Carotid artery stenting; In-stent thrombosis; Perioperative period

王翩，王琰，李虹庆. 颈动脉支架置入术后支架内血栓形成研究进展[J]. 中国卒中杂志, 2019, 14(06): 625-629.

WANG Pian, WANG Yan, LI Hong-Qing. Advance in Acute In-stent Thrombosis after Carotid Artery Stenting[J]. Chinese Journal of Stroke, 2019, 14(06): 625-629.

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