International Circulation: What is your advice on the effective management of complications from carotid stenting? 
国际循环： 对于颈动脉支架置入术并发症的有效管理，您的建议是什么？

Prof. Michael R. Jaff:   First of all， rapid recognition of the complication.  That is why you should not do these procedures under general anesthesia.  You really need to know when the patient is having a problem.  When you ask them to speak and they are unable to speak， you have to react immediately.  Number one is to have a baseline， 4-vessel， intracerebral angiogram so if there is a complication and you do another intracerebral angiogram you are able to see the lesion cut-off.  The next thing is， if the operator doesn’t know how to do it， to get a good neuro-interventionist to enter the cerebral vasculature with a good wire and a good catheter and aspirate the clot followed by intra-arterial lytic agent.  The goal is to try to restore blood flow as quickly as possible.  More recently， percutaneous thrombectomy has been introduced with devices like the MERCI Retrieval device.
Prof. Michael R. Jaff: 首先，尽早发现并发症。这就是为什么在全身麻醉时不能进行这些操作的原因。我们需要知道患者什么时候出现问题。当你让他们讲话，而他们无法说话的时候，就必须立即采取措施。首要的是要有一个基准的4支脑血管造影检查，所以如果有并发症，再做一次脑血管造影检查，就可以看到病变切断。其次是如果操作者不知道怎样做，要找到一位优秀的神经干预专家，用好的导线和导管，通过使用动脉内血块溶解剂吸出血块。目标是尽快恢复血液流动。

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