血管内支架成型术治疗颈动脉狭窄66例(2)
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2010年5月1日
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1.4 Treatment.Aspirin 100mg a day,clopidogrel 75mg a day were taken before 5 days of surgery,conventional preparation were done before cerebral angiography,0.1g phenobarbital were injected before 30min of operation.Using local anesthesia,ECG monitoring,oxygen,atropine ready to prepare for surgery applications.2% lidocaine local infiltration anesthesia.Punctured the femoral artery using Seldinger technique,8F arterial sheath,3000IU heparin subcutaneously,added 2000IU heparin every 1hour to extend the operation time foc,using he technology of guide wire and catheter,placed the 8F guiding catheter near the narrow blood vessels,after angiography,measured the length of stenosis and diameter of blood vessels,and understand the brain flow of the anterior artery and the middle cerebral artery.In the road-map,placed the EV3's SPIDERX distal protection device in proper place through the narrow area.If the degree of stenosis were bad,you need to pre-expand using different types of balloon to the narrowest part of the vessles.34 patients had pre-expansion and then,selected the appropriate EV3's PROTEGERX self-expanding stent and acrossed the stricture site,and released the stent in desired location,then the stent covering the narrow area.The principles of choosing the stent were according to the both ends of vascular lesion diameter and lesion length,the diameter of stent must be mached to the narrow diameter of the proximal blood vessels in order to maintain a good adherent of.
1.5 Perioperative period.Monitoring of vital signs after the operation within 24 to 48hours,giving antihypertensive therapy to high blood pressure,Nitroglycerin 10mg+0.9% sodium chloride 50ml were injected with the micro-infusion pump,usually blood pressure must controled around 120/70mmHg,the principles of controling blood pressure were the basis ofblood pressure,reached the 2/3's level of the basis of blood pressure,in order to prevent the original ischemic of brain tissue perfusion over the region because of the lower blood pressure,or leading to the brain hemorrhage because of over-reperfusion injury ......
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