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目的探讨颈动脉支架置入术(CAS)在预防脑梗死方面的远期效果。方法选择接受颅外段CAS患者55例,定期随访3年。根据CAS后发生缺血性脑血管事件(4例)和未发生缺血性脑血管事件(51例)进行比较。并分析CAS后血管再狭窄情况。结果在55例完成3年随访的CAS患者中,4例(7.3%)出现了终点事件的患者均为脑梗死。其中3例患者缺血事件对应的脑梗死在支架置入同侧,1例患者缺血事件对应的脑梗死在支架置入对侧。单因素分析发现,年龄>75岁、高血压史、有两个以上脑血管病危险因素、术后未系统服用抗血小板药物、术前有多次脑梗死病史的患者术后容易发生缺血性脑血管事件(P<0.05)。3年随访观察,有3例(5.5%)发生了再狭窄。结论 CAS能有效降低动脉粥样硬化性颈动脉狭窄患者脑卒中发生风险。CAS后中远期再狭窄率较低。
Objective To investigate the long-term effect of carotid artery stenting (CAS) in preventing cerebral infarction. Methods Fifty-five patients with extracranial CAS were selected and followed up for 3 years. According to CAS after ischemic cerebrovascular events (4 cases) and no ischemic cerebrovascular events (51 cases) were compared. And analysis of CAS restenosis. Results Of the 55 CAS patients who completed 3 years of follow-up, all 4 patients (7.3%) had a final infarction. Among them, 3 cases of cerebral infarction corresponding to ischemic event were placed on the same side of the stent, and 1 case of ischemic stroke corresponded to cerebral infarction on the opposite side of the stent. Univariate analysis found that patients> 75 years of age, history of hypertension, two or more risk factors for cerebrovascular disease, postoperative non-systemic antiplatelet drugs, preoperative multiple history of cerebral infarction patients prone to ischemic Cerebrovascular events (P <0.05). Three years of follow-up observation showed that three cases (5.5%) had restenosis. Conclusion CAS can effectively reduce the risk of stroke in patients with atherosclerotic carotid artery stenosis. CAS restenosis rate is low in the future.