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颅内椎基底动脉狭窄的支架成形术治疗
http://www.100md.com 2004年10月10日 本会
     上海长海医院神经内科 (200433)

    【摘要】目的:初步总结血管内支架成形术治疗颅内椎基底动脉狭窄的经验,探讨治疗的可行性、安全性及有效性,分析技术要点和围手术期处理。

    方法:42例43个颅内椎基底动脉狭窄进行了支架植入扩张成形治疗,其中颅内段椎动脉狭窄30个,基底动脉狭窄13个,术前平均狭窄程度(76.4±10.3)%(50%~90%),平均狭窄长度(6.7±3.2 )mm(3~12 mm),植入球囊扩张支架42枚。

    结果:41例42个狭窄支架植入成功,狭窄率降低到 (10.3±5.4)%,无夹层、血管破裂、支架内急性闭塞并发症,手术造成缺血性卒中1例(2.4%),无死亡。临床随访6~40个月,无脑缺血性事件发生,血管造影随访15例,发生再狭窄3例。结论:症状性颅内椎基底动脉狭窄的血管内支架成形治疗是一种有效、安全的方法,但再狭窄率及远期结果仍需要进一步积累病例及长期随访。
, 百拇医药
    【关键词】椎底动脉供血不足;支架;血管成形术;介入性

    Stent-assisted angioplasty of intracranial vertebrobasilar artery stenosis

    LIU Jianmin, HONG Bo, XU Yi, et al.

    Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China.

    【Abstract】Objective:To evaluate the feasibility, safety, and efficacy of endovascular stent-assisted angioplasty for the treatment of vertebrobasilar artery stenosis, and to discuss our preliminary experience and perioperative management. Methods: Fourty-two symptomatic patients with 43 intracranial vertebrobasilar stenoses presented with recurrent transient ischemic attacks or with history of infarction of posterior circulation territory were treated with balloon-expanded stents. The locations of stenoses were intracranial vertebral artery in 30 and basilar artery in 13. The average stenosis rate was (76.4±10.3)%(50%-90%)and the length of the stenosis was (6.7±3.2) mm of average (3-12mm). Results: The technique was successful for Fourty-one cases with 42 stenoses without procedural and perioperative death or major stroke. One minor stroke (2.4%) occurred in one patient of combined vertebral and basilar stenoses during operation. The average residual stenosis after stenting was (10.3±5.4)%. There was no death or cerebral ischemic attach for all patients who were clinical followed for 6 to 40 months after stenting. Three restenosis was noted for the 15 patients who were angiographically followed for an average of 8.5 months after treatment. Conclusion: Endovascular stenting for vertebrobasilar artery stenosis is effective and safe. But the long-term results need further investigation.

    【Key words】vertebrobasilar insufficiency stent angioplasty intervention, 百拇医药(刘建民 洪波 许奕 黄清海 赵文元)