目的分析总结神经内科19例经皮血管内支架治疗颈动脉狭窄的手术方法、适应症选择和并发症的预防。方法均经CTA或造影确诊,采用经股动脉入路,应用自膨式支架对颈动脉颅外段狭窄进行治疗。结果 19例手术18例获得成功,颈动脉狭窄得到有效改善,临床缺血症状术后得到明显改善,18例患者共置入颈动脉支架20枚、使用保护伞18个,其中2例患者分别于左右侧颈内动脉各植入1枚支架。回收的过滤伞中4个发现组织碎片。8例患者出现迷走反射均在球囊扩张及支架置入后,经对症处理全部缓解。6～30个月临床中短期随访12例,平均随访22个月。1例患者发生急性心肌梗死7d后死亡;1例患者出现小卒中;1例患者出现一过性脑缺血发作。随访12例支架全部开通良好,未出现再狭窄。随访6～30个月,未发现明显脑缺血发作,无B超发现支架内再狭窄病例。1例手术不成功。结论血管内支架成形治疗颅外段颈动脉狭窄是安全、有效的方法。 Objective To analyze and summarize the surgical treatment of 19 cases of carotid artery stenosis treated with endovascular stent in the department of neurology, the choice of indications and the prevention of complications. Methods CTA or angiography confirmed by the approach of the femoral artery, the application of self-expanding stent in the treatment of extracranial carotid artery stenosis. Results 18 cases were successful in 19 cases, the stenosis of carotid artery was effectively improved and the symptom of clinical ischemia was improved obviously. Twenty carotid stents were placed in 18 cases and 18 were used umbrella, of which 2 cases were involved Side carotid artery implantation of a stent. Four of the recovered filter umbrellas found tissue debris. 8 cases of patients with vagal reflex in the balloon dilatation and stent implantation, the symptomatic treatment of all relief. Six to 30 months clinical short-term follow-up of 12 cases, with an average follow-up of 22 months. One patient died of acute myocardial infarction 7 days later; one patient developed minor stroke; one patient developed transient ischemic attack. All the 12 cases were followed up and no stent restenosis occurred. Follow-up 6 to 30 months, no significant ischemic attack was found, no cases of intra-stent restenosis were found. One case was unsuccessful. Conclusion The treatment of extracranial carotid artery stenosis with stenting is a safe and effective method.