【正文】
一) ?術(shù)前是否停用抗高血壓藥物 ?釋放支架前如何控制高血壓 ?是否常規(guī)預(yù)防性使用阿托品 ?怎樣的患者需要安置臨時起搏器 ?支架后低血壓該如何處理 低血壓 amp。 49:857– 863. 頸動脈狹窄 支架治療的病例選擇 頸動脈狹窄的治療 ?Established for selected patients ?Antiplatelet therapy 抗血小板 ?Statin agents 他丁類藥物 ?Carotid endarterectomy 頸動脈內(nèi)膜剝離術(shù) ?Angioplasty and stenting ?Under investigation正在確立的新療法 ?Extracranial to Intracranial bypass ?Atherectomy 動脈狹窄旋切術(shù) ?Laser Assisted Angioplasty 激光輔助的血管成型術(shù) ?Thrombolysis – Angiojet 血管射頻消融術(shù) Carotid endarterectomy (CEA) is a surgical procedure removing plaque material from the lining of an artery The procedure to remove plaque buildup from an artery. A surgeon scrapes away the arterial lining, where plaque has formed, and the artery is stitched closed. Endarterectomy: researches 研究結(jié)果 ?North American Symptomatic Carotid Endarterectomy Trial (NASCET) ?European Carotid Stenosis Trial (ECST) Results: Dramatic risk reduction with surgery for severe stenosis 結(jié)果 :CEA明顯降低頸動脈嚴重狹窄患者的中風(fēng)危險性 NASCET. N Engl J Med 1991。 114:683S–698S 頸動脈狹窄的診斷 頸動脈狹窄定義 Paul HL Kao ?頸總動脈 (CCA)、分叉或頸內(nèi)動脈(ICA) 近段動脈硬化斑塊形成 ?斑塊潰瘍、血栓形成、或遠端栓塞是引起癥狀 (TIA/stroke/AF)的主要原因 ?動脈粥樣硬化 ?纖維肌發(fā)育不良 (fibromuscular dysplasia) ?高安氏病 ( Takayasu‘s Arteritis) ?血管炎( vasculitis) (包括放療后 ) ?與神經(jīng)纖維瘤病相關(guān)的狹窄 頸動脈狹窄的原