• 1.復(fù)旦大學(xué)附屬中山醫(yī)院放射科(上海200032);;
  • 2.復(fù)旦大學(xué)附屬中山醫(yī)院血管外科;

目的　分析頸動脈支架成形術(shù)（CAS）后發(fā)生再狹窄的早期隨訪結(jié)果，為臨床治療和預(yù)防術(shù)后支架內(nèi)再狹窄（ISRS）提供依據(jù)。方法　2003年1月至2005年9月在我院行CAS治療的患者，分別于術(shù)后1、3、5、12和24個月行彩色多普勒超聲隨訪，分析術(shù)前及術(shù)中諸多高危因素對術(shù)后ISRS發(fā)生的影響。結(jié)果　共計(jì)37例患者接受了隨訪，其中，男性占91.9%（34/37），女性占8.1%（3/37）； 平均年齡（70.5±5.9）歲； 平均隨訪（12.2±7.7）個月。術(shù)后發(fā)生ISRS 16例(43.2%)，再狹窄程度≥50%者僅占2.7%（1/37）； 其余均為30%~50%的輕度狹窄； 3例女性患者均發(fā)生輕度狹窄。術(shù)后發(fā)生ISRS與患者性別、術(shù)中頸動脈球囊后擴(kuò)以及是否合并其他外周血管動脈粥樣硬化有關(guān)。結(jié)論　CAS術(shù)后重度ISRS發(fā)生率較低； 女性患者CAS術(shù)后可能更容易發(fā)生ISRS； 術(shù)中球囊后擴(kuò)對預(yù)防再狹窄可能有一定的作用； 頸動脈狹窄的患者應(yīng)同時加強(qiáng)對動脈粥樣硬化的治療。

引用本文： 周波,竺挺,符偉國,顏志平. 頸動脈支架內(nèi)再狹窄的早期隨訪結(jié)果分析. 中國普外基礎(chǔ)與臨床雜志, 2006, 13(6): 662-664. doi: 復(fù)制

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  2. 2. 　Yadav JS, Wholey MH, Kuntz RE, et al. Protected carotid-artery stenting versus endarterectomy in high-risk patients [J]. N Engl J Med， 2004; 351(15)∶1493.
  3. 3. 　Bergeron P, Roux M, Khanoyan P, et al.Long-term results of carotid stenting are competitive with surgery [J]. J Vasc Surg， 2005; 41(2)∶213.
  4. 4. 　Frericks H, Kievit J, van Baalen JM, et al. Carotid recurrent stenosis and risk of ipsilateral stroke: a systematic review of the literature [J]. Stroke， 1998; 29(1)∶244.
  5. 5. 　Moore WS, Kempczinski RF, Nelson JJ, et al. Recurrent carotid stenosis: results of the asymptomatic carotid atherosclerosis study [J]. Stroke， 1998; 29(10)∶2018.
  6. 6. 　Endovascular versus surgical treatment in patients with carotid stenosis in the Carotid and Vertebral Artery Transluminal Angioplasty Study (CAVATAS): a randomised trial [J]. Lancet， 2001; 357(9270)∶1729.
  7. 7. 　Lal BK, Hobson RW 2nd. Management of carotid restenosis [J]. J Cardiovasc Surg (Torino)， 2006; 47(2)∶153.
  8. 8. 　Powell RJ, Schermerhorn M, Nolan B, et al. Early results of carotid stent placement for treatment of extracranial carotid bifurcation occlusive disease [J]. J Vasc Surg， 2004; 39(6)∶1193.
  9. 9. 　Criado FJ, Lingelbach JM, Ledesma DF, et al. Carotid artery stenting in a vascular surgery practice [J]. J Vasc Surg， 2002; 35(3)∶430.
  10. 10. 　Henry M, Amor M, Klonaris C, et al. Angioplasty and stenting of the extracranial carotid arteries [J]. Tex Heart Inst J， 2000; 27(2)∶150.
  11. 11. 　Toma N, Matsushima S, Murao K, et al. Histopathological findings in a human carotid artery after stent implantation. Case report [J]. J Neurosurg， 2003; 98(1)∶199.
  12. 12. 　Willfort-Ehringer A, Ahmadi R, Gschwandtner ME, et al. Healing of carotid stents: a prospective duplex ultrasound study [J]. J Endovasc Ther， 2003; 10(3)∶636.
  13. 13. 　Cunningham EJ, Bond R, Mehta Z, et al. Long-term durability of carotid endarterectomy for symptomatic stenosis and risk factors for late postoperative stroke [J]. Stroke， 2002; 33(11)∶2658.
  14. 14. 　Chakhtoura EY, Hobson RW 2nd, Goldstein J, et al. In-stent restenosis after carotid angioplasty-stenting: incidence and management [J]. J Vasc Surg， 2001; 33(2)∶220.
  15. 15. 　 Zhou W, Lin PH, Bush RL, et al. Management of in-sent restenosis after carotid artery stenting in high-risk patients [J]. J Vasc Surg， 2006; 43(2)∶305.
  16. 16. 　Setacci C, de Donato G, Setacci F, et al. In-stent restenosis after carotid angioplasty and stenting: a challenge for the vascular surgeon [J]. Eur J Vasc Endovasc Surg， 2005; 29(6)∶601.
  17. 17. 　Choi HM, Hobson RW, Goldstein J, et al. Technical challenges in a program of carotid artery stenting [J]. J Vasc Surg， 2004; 40(4)∶746.
  18. 18. 　Setacci C, de Donato G, Setacci F, et al. Surgical management of acute carotid thrombosis after carotid stenting: a report of three cases [J]. J Vasc Surg， 2005; 42(5)∶993.