Objective To explore the clinical application of the self-expandable stents in the treatment of carotid artery stenting (CAS) for the bifurcation stenosis. Methods The clinical data of 212 patients with CAS using distal filter protection of brain were analyzed retrospectively, including 42 patients with closed loop stent, 170 patients with open loop stent. The hemodynamic changes within 24 hours after surgery,the incidence of difficult recovery of distal filter brain protection , hospital stay, the United States National Institutes of Health Stroke Scale (NIHSS) rating score before and after treatment,degree of stenosis assessed systolic peak velocity and end diastolic velocity of carotid stenosis by ultrasonography at 12-month after treatment, the end events such as died after treatment, stroke or myocardial infarction were observed. Results There were no significant differences in hospital stay, all levels of the NIHSS score before and after treatment, degree of carotid stenosis after treatment for 12 months, accumulative incidence of end events after treatment within 30 days and 31 days to 12 months ( P>0.05 ). There were significant differences in the incidence of difficult recovery of distal filter brain protection and hemodynamic changes within 24 hours after surgery (P<0.05). Conclusion After sufficient preoperative preparation and proper stent selection, there are no significant differences in efficacy and complications between two types of stents, except larger hemodynamic changes within 24 hours after surgery and more difficult distal filter brain protection recovery for open-loop self-expanding stent.%目的探讨自膨支架在颈动脉分叉狭窄支架置入术（CAS）临床应用。方法回顾性分析实施远端过滤脑保护212例CAS患者的临床资料，其中42例患者植入闭环支架（闭环支架组），170例患者植入开环支架（开环支架组）。观察两组患者的术后24小时内血流动力学变化、远端过滤脑保护装置回收困难的发生率、住院天数和治疗前后美国国立卫生研究院卒中评分量表（NIHSS）评分、治疗后12个月内狭窄处血管超声收缩期最大峰值速度和舒张末期流速评估狭窄程度以及治疗后死亡、脑卒中或心肌梗死等终点事件。结果两组在住院天数和治疗前后NIHSS评分各层次、12个月颈动脉狭窄程度、治疗后30天内及31天至12月终点事件的累计发生率方面比较，差异无统计学意义( P＞0.05)；远端过滤脑保护装置回收困难和术后24小时内血流动力学变化差异有统计学意义（P＜0.05）结论经过充分术前准备且合理选择支架，植入自膨式开环支架除术后24小时内血流动力学变化较大和远端过滤脑保护装置回收困难外，两种类型自膨支架在CAS中的疗效和并发症发生率没有明显差别。
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