年龄对颈动脉支架置入并发症的影响。UAB神经血管成形术组。

H D Chastain, C R Gomez, S Iyer, G S Roubin, J J Vitek, J B Terry, R L Levine
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引用次数: 74

摘要

目的:探讨年龄对颈动脉支架植入术中及植入术后神经系统及主要系统并发症的影响。方法:回顾1994年9月至1996年8月间颈动脉支架植入术的并发症。然后将研究人群按年龄分为3组:>或= 80岁(A组)、75 ~ 79岁(B组)和<或= 74岁(C组)。比较两组之间的死亡率、主要和次要中风的发生率以及心肌梗死的发生率,并与颈动脉内膜切除术(CEA)试验报告的发生率进行比较。结果:在研究期间,182例患者(216条血管)接受了颈动脉支架置入术。并发症19例(10.4%):死亡1例(0.5%),重度卒中2例(1.1%),轻度卒中15例(8.2%),心肌梗死1例(0.5%)。神经系统并发症明显与年龄增加相关,A组为25.0%,C组为8.6% (p = 0.042)。每名患者死亡或主要中风的总发生率为1.6%(每条血管1.4%)。结论:年龄增加对颈动脉支架患者并发症发生率有负面影响。然而,这些并发症大多是轻微的。在> 80岁的患者中,药物治疗、支架植入和CEA的相对作用必须等待随机试验的结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Influence of age upon complications of carotid artery stenting. UAB Neurovascular Angioplasty Team.

Purpose: To examine the impact of age upon the development of neurological and major systemic complications during or after carotid artery stenting.

Methods: We reviewed the complications that occurred in patients undergoing elective carotid stent implantation between September 1994 and August 1996. The study population was then divided into 3 groups according to age: > or = 80 (group A), 75 to 79 (group B), and < or = 74 (group C) years. The rates of death, major and minor stroke, and myocardial infarction were compared among the groups, as well as with the rates reported by the major carotid endarterectomy (CEA) trials.

Results: During the study period, 182 patients (216 vessels) were treated with carotid stenting. There were 19 (10.4%) complications: 1 (0.5%) death, 2 (1.1%) major strokes, 15 (8.2%) minor strokes, and 1 (0.5%) myocardial infarction. Neurological complications were clearly related to increased age with rates of 25.0% in group A versus 8.6% in group C (p = 0.042). The overall per patient rate of death or major stroke was 1.6% (1.4% per vessel).

Conclusions: Increasing age has a negative impact on the rate of complications in carotid stent patients. However, the majority of those complications are minor. The relative roles of medical therapy, stenting, and CEA in patients > 80 years of age must await the results of randomized trials.

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