| Objective:(1) To explore the surgical method, clinical effect and safety of stent angioplasty of the internal carotid artery stenosis.(2) To discuss its indications, technical points and the prevention of perioperative complications.Methods:(1) 20 patients with stenting testify of extracranial stenosis of internal carotid artery were selected as the treatment group(symptomatic stenosis of internal carotid artery≥50%, asymptomatic stenosis≥75%), which was given the stent angioplasty.W hile the control group included 20 patients whose stenosis of internal carotid aretery had reached the stenting testify. But they accepted conservative treatment instead o f the stent angioplasty(to control the risk factors and apply symptpmatic treatment s uch as reducing lipid, depressurization and controlling diabetes). There were no sig nificant difference between the treatment group and control group in stroke risk fa ctors such as age, sex, and background disease(high blood pressure, diabetes, and hyperlipidemia)(P>0.05). In addition to the stent-assisted angioplasty, the treatment g roup also receivedsame symptomatic treatment as the control group.(2) To examine the patients in two groups using the cervical vescular ultrasound, transcranial dopp ler ultrasonography(TCD), CT, MRI, MRA, CTP, and digital subtraction angiograph y(DSA), and to score the two groups at different times with the United States nati onal institutes of health stroke scale score(NIHSS) and ADL, and to investigate t he recurrence of stroke within six months etc.(3) The internal carotid artery stentangioplasty used local anesthesia, Seldinger puncture technology, spiders embolism p rotection device(American EV3 production), an PROTEGERX self-expanding stents(American EV3 production). It was analyzed that the change of the stenosis rate, th e change of Two groups of patients in clinical symptoms, the NIHSS and ADL sco res,the surgical keys, the perioperative care, and complication efore and after stent-a ssistedangioplasty.Results:(1) The success rate of stent-assisted angioplasty in treatment group was 100%. The stenosis degree after stent-assisted angioplasty of carotid artery dropped fr om(87.65±7.63)% to(12.58±4.83)%, and the maximum flow velocity at stenosis d eclined from(190.27±16.73)cm/s to(92.68±6.23)cm/s after surgery(P<0.01). 5 cases appeared transient drop in blood pressure and heart rate. 8 cases appeared persiste nt low blood pressure and low heart rate. 6 cases had the perioperative performanc e of perfusion in transition performance without serious complications such as hemo rrhage. The CBF and CBV were obviously improved in treatment group before and after operation(P<0.05). No restenosis was found at the site of stent in the tre atment group following up for 6 months.(2) The ADL and NIHSS score of treatm ent group were better than that of control group(P<0.05).(3) In 6 months no recurr ence of stroke happens in the treatment group,while 4 case in control group(P<0.05).(4) There was a significant statistical difference between the treatment group an d the control group in restroke number with 0 to 4(P<0.01).Conclusion:The application of self-expanding stent angioplasty to cure extracranial carotid stenosis had a great clinical effect. If we chose the indication correctly and handled properly during perioperation, there would be fewer complications, faster recovery, higher safety, and lower rate of recurrence of stenosis. This technic was better than conservativemedical treatment in improving quality of patients’ life and preventing recurrence of stroke. |
PDF Full Text Request