高龄患者颈动脉支架置入效果和安全性分析

Safety and efficacy of angioplasty and stenting for elderly patients with carotid artery stenosis

摘要:

目的: 探讨高龄颈动脉狭窄患者施行血管内支架成形术治疗的可行性和安全性.方法: 回顾性分析2009年12月至2011年5月间首都医科大学宣武医院神经介入放射诊疗中心实施脑保护下血管内支架置入治疗22例超高龄颈动脉狭窄病人的临床资料,其中男16例,女6例,年龄80-85岁,平均81.8岁.21例单侧颈动脉狭窄放置1枚支架;1例左侧颈动脉狭窄合并左椎动脉狭窄同时进行了治疗,分析患者的疗效及并发症等.结果: 在围手术期内出现严重并发症2例,术中出血1例,1例术后10小时出现心跳骤停,围手术期并发症发生率为9.1%,高于可以接受的6%,对所有病例随访3-18个月(平均7个月),按mRS评分0分20例,7分1例,无一例出现新发神经功能障碍.结论: 高龄患者行颈动脉支架成形术的安全性和有效性还需进一步评价.

Abstract:

Objective: To investigate the feasibility and safety of intravascular stenting in the elderly patients with carotid artery stenosis.Methods: The clinical data of 22 very elderly patients with carotid artery stenosis received intravascular carotid stenting in Xuanwu hospital from Dec 2009 to May 2011.There were 16 males and 6 females among them,aged with 80-85 years old,means 81.8 years.21 patients undergone one side carotid stenting and 1 with left vertebral artery stenting.The efficacy and complications of the patients were analyzed.Results: The occurrence of complications:2 cases appeared serious complications in the perioperative period,1 had postoperative bleeding,and 1 had suffered cardiac arrest.The overall incidence of complication rate was 9.1%,It Higher than the acceptable 6%.22 patients were followed up for 3-18 months(mean 7 months),the modified Rankin scale(mRs) score were o(20 patients),7(1 patients).All the patients had no new neurological deficits or original symptom deterioration.Conclusions: The security and effectiveness of placing carotid stents for elderly patients with extracranial carotid stenosis should be further evaluated.