支架成形术治疗伴发眩晕的椎-基底动脉中重度狭窄的疗效分析.pdfVIP

· 59 · · 论著 · 支架成形术治疗伴发眩晕的椎 一基底动脉中重度狭窄的 疗效分析 胡沛霖，王文胜，李喜朋，王建民，周建峰 【摘要】 目的 探讨支架成形术治疗伴发眩晕的椎一基底动脉中重度狭窄的安全性及近期疗效。方法 回顾性分 析33例伴发眩晕的椎一基底动脉中重度狭窄患者的临床表现、行支架成形术情况、术后并发症及术后随访 1年疗效。 结果 血管狭窄部位 ：椎动脉起始段24例、颅 内段4例，基底动脉5例。MoliA型病变25例、MoriB型病变8例。支 架成形术成功率为100％，平均狭窄率从 85％ (70％ 一95％)下降到 15％ (0—2O％)。随访 1年，33例患者无脑卒中 事件发生，眩晕发作消失29例，轻度发作3例，无明显改善 1例。结论 支架成形术治疗症状性椎 一基底动脉中重度 狭窄安全、有效，特别对伴发眩晕的患者症状改善近期疗效明显。 【关键词l 眩晕；椎基底动脉供血不足；支架成形术；治疗结果 【中图分类号】R743 【文献标识码】A 【文章编号】1007—9572(2012)O1-0059一o3 TheEffectofStentAngioplastyinTreatingMiddleorSevereVertebral—BasilarArteryStenosiswjthEpisodicVertigo HUPei—lin，WANGWen—sheng，LIXi—peng，eta1．DepartmentofNeurology，ThePeopleSHospitalofXingta，Xingtai 054001，China A【bstract】 Objective Toexploretheshort—termeffectandsafetyofstcntingintreatingmiddleorseverevertebral— basilararterystenosiswithepisodicvertigo．Methods 33 patientswhosufferedfrom middleorseverevertebral—basilarartery stenosiswithepisodicvertigo，acceptedstentingtreatmentTheirclinicalmanifestation，intraoperativeconditions，postoperative complicationsandpostoperativefollow—uponeyearlaterwereanalyzed．Results Intermsofthesitesappearingvascularsteno· sis，24caseswereinvertebralartery initialsegment，4casesinintracranial segmentand5casesinbasilarartery．Amongthe33 cases，therewere25withMoriA —typestenosiSand8withMoriB —typestenosis．Operationachievementratiowas100per- cent．Averagestenosisratiodescendedfrom85percent(70～95percent)to15percent(0—20percent)．Duringoneyearof postoperativefollow—up，all0f33patientsdidnotsufferrfom ischemieevents．ThesympotomsofEpisodicvertigosubsidedin29 cases，lessenedin3cases，anddidnotimprovein1case．Conclusion StentAngioplastywassafeandeffectiveintreatingmid— dieorseverevertebral—basilararterystenosis，andespeciallysignificantinimprovingtheshort—temr symptomsofep