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目的研究颅外段颈内动脉(EICA)狭窄支架植入术(CAS)治疗前后颅内、外动脉血流动力学的变化。方法用彩色多普勒血流显像(CDFI)和经颅彩色多普勒血流显像(TCCD)分别对38例EICA狭窄患者CAS治疗前、后狭窄局部管径、收缩期峰值流速(PSV)及同侧大脑中动脉、眼动脉PSV、搏动指数(PI)和颅内侧支循环的建立情况进行分析。结果CAS术后患侧原狭窄处内径较术前明显增宽(P<0.001),仍小于对侧(P<0.001);PSV较术前明显降低(P<0.001),仍大于对侧(P<0.05)。CAS术后患侧大脑中动脉、眼动脉的PSV、PI较术前明显增高(P<0.001),与对侧比较差异无统计学意义(P>0.05)。侧支循环全部关闭。结论CDFI与TCCD结合可评价CAS治疗前、后颅内、外动脉的血流动力学变化,对判断CAS疗效具有重要的临床价值。CAS是治疗EICA狭窄安全而有效的方法,短期疗效令人满意。
Objective To study the changes of intracranial and extra-arterial hemodynamics before and after extracranial carotid artery (EICA) stenosis stent implantation (CAS). Methods CDFI and TCCD were used to evaluate the changes of local diameter of stenosis, peak systolic velocity (PSV) before and after CAS in 38 patients with EICA stenosis, ) And ipsilateral middle cerebral artery, ocular artery PSV, pulsatility index (PI) and intracranial collateral circulation were analyzed. Results The diameter of the contralateral stenosis at CAS was significantly larger than that before operation (P <0.001), but still less than that at the contralateral side (P <0.001). PSV was significantly lower than that before operation (P <0.001) <0.05). The PSV and PI of the ipsilateral middle cerebral artery and the ophthalmic artery in CAS were significantly higher than those before surgery (P <0.001). There was no significant difference between the two groups (P> 0.05). Collateral circulation all closed. Conclusions The combination of CDFI and TCCD can evaluate the hemodynamic changes of intracranial and extracranial arteries before and after CAS treatment. It has important clinical value in judging the therapeutic effect of CAS. CAS is a safe and effective method of treating EICA stenosis with satisfactory short-term efficacy.