关键词: 脑血管疾病, 支架置入, 并发症, 防治, 医学植入物

Abstract:

OBJECTIVE: To summarize and analyze the occurrence, prevention and treatment of complications of ischemic cerebrovascular disease following stent implantation.
METHODS: We retrieved Science Direct database and Ei database for relevant articles published from January 1960 to October 2009. The key words included “cerebral disease, fracture, stenting” in English. Simultaneously, we retrieved Chinese Journal Full-text Database and Chinese Biomedical Literature Database for relevant articles published from January 1994 to October 2009, with the key words of “cerebrovascular disease, stent implantation, biomaterial” in Chinese. In addition, several relevant literatures were looked up by hand. Studies concerning treatment manners of stent implantation in treatment of cerebrovascular disease were included.
RESULTS: Following stent implantation for cerebrovascular disease, common complications contained contrast medium-related complications, such as anaphylactoid reaction, nephrotoxicity, aggravated cardiac load and so on; puncture site complications, such as hematoma, tunica intima laceration-induced secret compartment isolation and severe pelvic cavity bleeding; carotid sinus reflex, such as blood pressure decrease, decreased heart rate, sudden cardiac arrest, even death, serious cardiac arrhythmias and acute myocardial infarction; ischemic stroke; luxury perfusion syndrome, which can induce fatal hemorrhage sometimes; long-term complications, such as restenosis, stent collapse, deformation, displacement and so on. Therefore, protective umbrella technique during surgery can significantly decrease the incidence rate of embolism induced by atherosclerotic plaque desquamation. Transcranial Doppler technique was used during the surgery to promptly find vessel spasm or occlusion. Early application of urokinase and papaverine can lead to complete remission in patients. Intramuscular atropine was utilized to elevate heart rate prior to stent implantation in patients with carotid sinus dysfunction and sinus bradycardia. Following stent implantation, blood volume was enlarged and appropriate pressor agents were taken according to blood pressure.
CONCLUSION: During stent implantation for cerebrovascular disease, we can achieve prospective outcomes through making entire diagnostic regulation and operation pre-, in- and post-implantation, promptly finding abnormal condition and effectively managing.