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颈动脉血管成形和支架置入术(Carotid angio plasty and stenting,CAS)是包括颈动脉球囊扩张术和支架置入术在内的介入治疗手段。CAS已经被证实是一种治疗颈动脉狭窄和预防卒中的有效方法。尽管CAS是一种微创手术,且手术器材及技术有了很大的改进,但仍然存在许多潜在的并发症,其中围手术期卒中仍是一个令人关注的问题。操作者技术熟练程度、术前病人的筛选、CAS器材的选择(包括栓子保护装置和支架的选择)、颈动脉斑块性质的确定等与围手术期卒中的发生密切相关。充分认识CAS围手术期卒中发生风险因素有利于CAS病例及器材的合理选择,尽可能降低围手术期卒中发生率。本文就CAS围手术期卒中发生风险因素做一个分析。
Carotid angioplasty and stenting (CAS) are interventional treatments including carotid balloon dilatation and stenting. CAS has proven to be an effective method of treating carotid stenosis and preventing stroke. Although CAS is a minimally invasive procedure and has greatly improved surgical equipment and techniques, there are still many potential complications. Perioperative stroke remains a concern. Operator proficiency, screening of preoperative patients, selection of CAS equipment (including the selection of embolic protection device and stent), determination of carotid plaque properties and so on are closely related to the occurrence of perioperative stroke. To fully understand the risk factors of CAS perioperative stroke is conducive to the rational selection of CAS cases and equipment and to minimize the incidence of perioperative stroke. This article makes an analysis of the risk factors for perioperative stroke in CAS.