【摘要】 目的 探讨血管内支架成型术治疗颈动脉狭窄的临床效果和安全性。方法 对21例颈动脉狭窄患者，先行血管造影，然后根据血管狭窄情况，选择合适自膨式支架跨过狭窄部位，将支架送至预想的位置释放，覆盖狭窄部位。结果 治疗狭窄动脉21支，狭窄程度均明显改善，狭窄程度由原来的(78.94±12.8)%下降至(3.19±3.04)%，无死亡病例，术后患者症状均明显改善，围术期无并发症。随访1～12个月，颈动脉超声检查治疗血管无再狭窄。结论 只要适应证选择正确，围术期处理得当，血管内支架成型术治疗颈动脉狭窄，不仅临床效果好，而且安全性高。
【关键词】 血管内支架成型术;颈动脉狭窄;脑缺血发作
Angioplasty and Stenting for 21 Cases of Symptomatic Carotid Artery Stenosis
Wang Qian, Zhu Qing-feng, Wang Guo-fang, Bian Shi-chun (PLA No.264 Hospital, Taiyuan 030001, China)
Abstract： Objective To analyze the treating result of symptomatic carotid artery stenosis with angioplasty and stenting, was well as their safety. Methods A total of 21 patients with symptomatic carotid artery stenosis were treated with angioplasty and stenting between July 2006 and December 2007. Results As a result, 21 stenosed branches of arteries were treated. The stenosis was decreased from 78.94%±12.8% to 3.19%±3.04% (of diameter). No death occurred. The symptoms or signs (complaint) were improved excellently after angioplasty and stenting, and no one experienced procedure-related complication. The patients were followed up for 1-11 months, and no restenosis was found by ultrasonic examination of carotid artery. Conclusion The therapy with angioplasty and stenting is safe and valid for symptomatic carotid artery stenosis. But the selection for indications, the special treatment during operation and the skillful technique were the keys to success.
Key words： stenting angioplasty; carotid artery stenosis; attack of brain ischemia
脑卒中是造成人类死亡的第2位疾病，其中以缺血性脑血管病所占比例最大，颈动脉狭窄是缺血性脑卒中的常见原因。颈动脉内膜切除术(Carotid endaterectomy，CEA)是治疗颈动脉狭窄，降低中风的有效的方法，随着材料学技术的进步，经血管内支架成型术有取代CEA的趋势，我院2006年7月—2007年12月，采用血管内支架成型术治疗颈动脉狭窄21例，效果良好，现报告如下。
1 对象和方法
1.1 对象 颈动脉狭窄21例，男性8例，女性1例，年龄52~75岁。21例患者均有短暂性脑缺血反复发作表现，12例表现为说话不流利，一侧肢体无力，9例患者有反复头晕表现，7例有头重感觉，2例性格改变，沉默寡言、反应迟钝。 14例有高血压，8例有糖尿病，5例有冠心病。
1.2 颈动脉狭窄程度 全组病例经颅多普勒均提示颅内血管供血不足，颈部血管彩超均提示颈动脉狭窄，并都有
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