Carotid stenting: which stent for which lesion?
Carotid stenting: which stent for which lesion?
复制标题
颈动脉支架置入术：哪种支架适合哪种病变？
DOI：
10.1111/j.1540-8183.2001.tb00380.x
复制
发表时间：
2001
影响因子：
2.1
通讯作者：
T. Ischinger
中科院分区：
文献类型：
--
作者：
T. Ischinger
用于颈动脉循环的专用导管和支架系统最近才被开发出来。几乎完全使用自扩张金属支架。纵向柔韧性、管腔结构的轮廓性、足够的径向阻力、用于密封病变血管壁的狭窄网状结构、限制型支架的低切迹以及器械与常规血管成形术技术的兼容性是首要要求。目前的大多数经验是基于纵向金属丝网设计（颈动脉壁支架）。狭窄的网状结构具有出色的密封能力，但需要注意的是，随着膨胀而缩短的固有（但可管理的）问题。最近的镍钛合金支架的分段环设计允许更精确的定位和管腔表面的轮廓，但其密封复杂或血栓性病变的能力及其临床安全性需要进一步评价。随着专用颈动脉支架的更多独特特征的开发以及其不同重要性的认识，针对颈动脉解剖结构的更有意义和个性化的支架选择可能进一步改善临床结局。
Dedicated catheter and stent systems for use in the carotid circulation have only been developed recently. Almost exclusively, self-expandable metallic stents are being used. Longitudinal flexibility, contourability of the luminal configuration, sufficient radial resistive force, narrow meshwork for sealing of the diseased vessel wall, low profile of the constraint stent, and compatibility of the devices with routine angioplasty techniques are the premier requirements. Most of the current experience is based on the longitudinal wire mesh design (Carotid Wallstent). The narrow meshwork has excellent sealing capacity but the inherent (yet manageable) problem of foreshortening with expansion needs attention. The segmented ring designs of the more recent Nitinol stents permit more precise positioning and contouring of the luminal surface, yet their capacity to seal a complex or thrombotic lesion and their clinical safety needs further evaluation. As more distinct features of dedicated carotid stents are being developed and as their differential importance gets recognized, a more meaningful and individual stent selection for the carotid anatomy may further improve clinical outcome.