Clinical Study On Stent-Assisted Angioplasty For Stenosis Of Intracalvarium Of Internal Carotid Artery

OBJECTIVE(1) To approach the safety and availability of stent-assisted angioplasty for stenosis of intracalvarium of internal carotid artery;(2) To approach the indication,skill points,prevention and cure of periprocedural complication.METHODS Thirteen patients with stenosis of intracalvarium of internal carotid artery,9 males,4 females,Aged 49～76 years,average age was 63.00±8.10 years old.The stenosis degree were 70%～98%,mean was 85.40±8.26%.Patients reeeived examinations(include cervical Doppler sonography,TCD,CT or MRI,MRA,CTP,DSA) preprocedure,all of them were scored by NIHSS.Routine monitoring were given during the operation,with loal anesthesia or general anesthesia,and then Seldinger arteriopuncture,with 6F artery scabbard,guided under the 0.014"mini-guide wire,the stents were placed in the exact place of stenosis,vascular angiographies were taken immediately,the changes of Stenosis were observed and NIHSS were scored. And then observed the changes of clinical symptoms and physical signs,periprocedural complications and managements.All cases received follow-up.RESULTS(1) 10 patients were placed balloon expandable stents, operation achievement ratio was 76.92%.In 2 cases,the stents can't reach destination and change to PTA due to blood vessels were too curved.One patient emerged serious vasospasm during operation and then gived up.In the successful cases the stenosis degree was obviously improved.The mean degree of stenosis reduced from(85.40±8.26)%to(8.60±5.8)%(P＜0.05) and NIHSS was lower than preprocedure(P＜0.05).In 8 cases symptoms were disappeared and improved during periprocedural complication.3 patients appeared light complication,with no serious complication or death.(2) All patients received follow-up,2～41 months(mean 22.8 months) after placement of the stent.10 cases received TCD,4 CTA and 2 DSA. None of them were found restenosis,displacement or collapse.CONCLUSIONS(1)There is high operation achievement ratio of Stent-assisted Angioplasty for Stenosis of intracalvarium of internal carotid artery,and its complication is acceptable.It's a safe,effective treatment.(2) A further study is needed.