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颈动脉狭窄伴重度钙化的外科治疗探讨

章国新 柏骏 职康康

中国临床保健杂志2024,Vol.27Issue(3):297-303,7.
中国临床保健杂志2024,Vol.27Issue(3):297-303,7.DOI:10.3969/J.issn.1672-6790.2024.03.003

颈动脉狭窄伴重度钙化的外科治疗探讨

Surgical treatment strategies for carotid artery stenosis with severe calcification

章国新 1柏骏 1职康康1

作者信息

  • 1. 海军军医大学第二附属医院血管外科,上海 200070
  • 折叠

摘要

Abstract

Objective To explore the surgical treatment strategies and surgical techniques for carotid artery stenosis patients with severe calcification.Methods A total of 33 patients with carotid artery stenosis with severe calci-fication undergoing surgical treatment were selected from the Second Affiliated Hospital of Naval Medical University from January 2020 to June 2023.Individual selection of valgus CEA,patch CEA,carotid endarterectomy+artificial vascular interplacement,CAS under proximal brain protection,CAS under distal brain protection and TCAR were performed to an-alyze the characteristics and effects of different surgical methods.Results Among the 33 patients with carotid artery stenosis and severe calcification,14 patients(42.4%)underwent inversion CEA,6 patients(18.2%)underwent pa-tenting CEA,and 2 patients(6.1%)underwent CEA+artificial vascular replacement,3 patients(9.1%)with CAS protected by the proximal brain,7 patients(21.2%)with CAS protected by the distal brain,and 1 patient(3.0%)with TCAR.No serious neurological complications occurred after surgery.Symptoms improved or disappeared after 6 months of follow-up.Conclusions For patients with carotid artery stenosis accompanied by severe calcification,CEA is generally the first choice,and attention should be paid to the use of brain protection devices when selecting CAS to re-duce the risk of perioperative cerebral infarction.

关键词

颈动脉狭窄/血管钙化/手术策略/颈动脉内膜切除术/颈动脉支架成形术

Key words

Carotid artery stenosis/Vascular calcification/Surgical strategy/carotid endarterectomy/carotid ar-tery stenting

引用本文复制引用

章国新,柏骏,职康康..颈动脉狭窄伴重度钙化的外科治疗探讨[J].中国临床保健杂志,2024,27(3):297-303,7.

基金项目

国家自然科学基金面上项目(81971710) (81971710)

中国临床保健杂志

OACSTPCD

1672-6790

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