择期支架成形术治疗弓上颅外脑动脉狭窄远期疗效.docVIP

择期支架成形术治疗弓上颅外脑动脉狭窄远期疗效【摘要】 目的 研究择期血管内支架成形术治疗症状性颅外动脉狭窄的远期临床疗效。方法 对36例弓上颅外动脉狭窄的患者(40处病变)行血管内支架成形术治疗。临床随访观察4~33个月,平均18个月。结果 颅外动脉内支架成形术的技术成功率100%,血管狭窄由术前(72.12±8.86)%下降至术后(10.12±6.17)%。围术期内,1例(2.78%,1/36)发生原狭窄供血区轻微缺血性卒中,其余患者未发生手术相关并发症;临床随访无卒中复发或死亡,CT造影随访1例支架内轻度再狭窄。结论 血管内支架成形术治疗弓上颅外动脉狭窄远期疗效良好。 【关键词】 血管成形术;支架;颅外脑动脉;狭窄 Long-term Outcome of Elective Stenting for extracranial arterial Stenosis with Endovascular Stenting LIAO Geng,YANG Zhi,CHEN Hai,et al.Department of Neurology,Affiliated Maoming Hospital Of Southern Medical university //MaoMing People’s Hospital,Guang Dong 525000,China 【Abstract】 Objective The aim of this study was to demonstrate Long-term Outcome of Elective Stenting for extracranial arterial Stenosis with Endovascular Stenting.Methods 36 patients(40 arteries)underwent stent placement for extracranial arterial Stenosis.3 to 30 months follow-up was given to those patients,average 18 months.Results Procedural and clinical success was achieved in 40(100%)target vessel and 36(100%)patients,respectively.The degree of stenosis was reduced from a baseline of (72.12±8.86)%to (10.12±6.17)%.after stenting.1 patient(2.78%)had a slight stroke in periprocedure,the others free from periprocedural complications.Target vessel restenosis occurred in 1 patient with CTA examine.No patients had recurrence of stroke or mobitity.Conclusion The long-term outcome of endovascular stenting of extracranial arterial stenosis is safe and effective. 【Key words】 Angioplasty;Stenting;extracranial artery;Stenosis 弓上颅外动脉粥样硬化是缺血性卒中的主要原因。NASCET试验[1]证实了颈动脉内膜剥脱术(CEA)治疗颅外颈动脉高度狭窄(≥70%)优于单纯药物治疗。但我国开展CEA治疗颈动脉狭窄的例数甚少,远不能满足人们需求。血管内支架成形术(PTAS)已应用于治疗颅内外脑动脉狭窄,国内多项研究[2,3]显示近中期疗效良好,但远期疗效研究报道较少,现将我科择期PTAS治疗弓上颅外脑狭窄的1组病例回顾分析如下,探讨其远期疗效。 1 材料与方法 1.1 入选标准 ①弓上颅外段脑动脉狭窄:有与之相关缺血症状,血管管径狭窄程度大于等于50%;②无相关缺血症状,血管管径狭窄程度大于等于70%;③知情同意者。 排除:①脑动脉完全闭塞;②梗死后遗留严重神经功能障碍;③伴有颅内动脉瘤或动静脉畸形,且不能提前或同时处理者;③急性缺血性卒中2周内;④心、肝或肾功能衰竭患者;⑤4周内有外科手术史或创伤史者;⑥各种原因无法行数字减影血管造影(DSA)检查者;⑦无法联系或拒绝合作者。 1.2 一般资料 根据以上标准,选取我科于20