关键词：头臂动脉狭窄；并发症；介入放射学；血；管内支架
【摘要】 目的 探讨血管内支架治疗头臂动 脉阻塞性疾患中并发症的预防和治疗。 材料与方法 8例接受血管内支架成形术治疗的头臂动脉 阻塞性疾病患者分为颈动脉和锁骨下动脉两组，对在治疗过程中所出现的并发症及其治疗 处理进行回顾性比较分析。 结果 在颈动脉组4例中，有3例出现并发症，其中2例 出现一过性意识丧失，利用自身血液回灌技术预防了再发生。2例出现一侧肢体麻木，感觉 障碍，应用30～50万U尿激酶后缓解。2例术后严重头痛，经药物降低血压、颅压后缓解 。在4例锁骨下动脉组中，仅1例因导丝穿破血管而放弃治疗。在1～24个月的随访中，颈动 脉组中有1例9个月后闭塞。 结论 颈动脉血管内支架成形术的并发症明显高于锁骨 下动脉。因此，在血管内支架治疗头臂动脉阻塞性疾病时，要注意对颈动脉并发症的防治。
The Prevention and Cure of Complications during Stent Placement Procedures for Occlusive Diseases of Brachiocephalic Arteries
SUN Jianzhong HE Nengshu CHEN Guangli
(Department of Radiology, Genera l Hospital of Tianjin Medical University, Tianjin 300052, P.R.China )
【ABSTRACT 】 Objective To investigate the prevention and cure of complications during stent placement procedures for occlusive diseases of brachiocephalic arteries. Materials and Methods PTAS was performed in 8 pat ients with occlusive diseases of brachiocephalic arteries, who were divided into carotid group and subclavian group. The complications during PTAS procedures an d the management of them in each group were retrospectively compared and analyze d. Results Of 4 patients in carotid group, 2 occurre d TIA, which was successfully prevented from relapse by treating with auto-bloo d perfusion-back technique; 2 developed unilateral limb numbness and sensory di sturbance, which were relieved by administering 300,000 ～500,000U urokinase; 2 complained severe headache, which was remitted by lowering the blood and intr acranial pressure with medicine. In one case of subclavian group, the PTAS had t o be stopped halfway in the procedure, because the vessel was perforated by the guidewire. The vessel was occluded in one case of carotid group after 9 months. Conclusion Carotid PTAS carries higher incidence of complications than subclavian PTAS does. Therefore, great attention should be paid to the prevention of the carotid PTAS.
【Key words 】 Brachiocephalic artery stenosis Complication Interventional Radiology Intravascular stent
头臂动脉血管内支架成形术是一项新技术 ......
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