中文摘要：

目的 探讨老年症状性颈动脉狭窄患者的支架成形术和（或）内科治疗的安全性和短期疗效。方法 选择我院经数字减影血管造影术（DSA）证实有颈动脉狭窄且有相关临床症状的老年患者85例，均给予内科治疗，其中58例行颈动脉支架成形术，分析其临床、影像学、治疗和随访观察资料。结果 68例患者临床症状改善或消失；住院及随访期间6例（7．1％）发生脑卒中，无脑卒中相关死亡。本组中58例患者共置入支架67个，支架成形术成功率为100％，动脉狭窄率由术前（86．8±9．3）％降至（10．9±2．5）％（t=21．1，P=0．000）；术后30天内2例发生支架相关脑卒中；58例支架成形术患者平均随访28．3个月，50例（86．2％）症状改善或消失，2例发生同侧颈内动脉供血区域脑卒中；36例复查颈部血管超声，2例显示支架内再狭窄；10例复查DSA均未发现支架内再狭窄。结论老年症状性颈动脉狭窄患者的综合临床干预短期疗效良好；狭窄的支架成形术方法可行，相对安全。

英文摘要：

Objective To evaluate the safety and efficacy of appropriate treatment including carotid artery stenting （CAS） and/or medical therapy in elderly patients with symptomatic carotid artery stenosis. Methods Eighty-five elderly patients with symptomatic carotid artery stenosis demonstrated by digital subtraction angiography （DSA） were all treated with medical therapy. Some of them were treated with additional CAS. Their clinical, imaging, intervention and follow-up data were collected and analyzed. Results A stroke rate of 7. 1% and no stroke-related death were found in the eighty-five elderly patients during hospitalization and follow-up, with symptoms resolved or improved clinically in 68. Fifty-eight of the 85 patients received CAS and sixty-seven stents were placed. The technical success rate was 100 % and the mean degree of stenosis was reduced from （86.8±9.3）% before stenting to （10.9±2.5）% （ t =21.1, P =0. 000）. Perioperative procedure-related stroke occurred in 2 cases. During follow-up （mean 28.3 months）, symptoms were resolved or improved clinically in 86.2% of the patients who received CAS and two patients experienced ipsilateral carotid territory stroke. Duplex scan of 36 patients demonstrated two restenosis, while DSA follow-up demonstrated no restenosis. Conclusions Appropriate management may improve short-term outcomes of elderly patients with symptomatic carotid artery stenosis. Meanwhile, CAS is technically feasible and relatively safe.