全脑血管造影及血管内支架在缺血性脑血管病中应用探析.docVIP

全脑血管造影及血管内支架在缺血性脑血管病中应用探析 　 作者：陶中海，荣良群，魏秀娥，袁勇，朱本亮，杨森，王虎，龚爱平 【关键词】 数字减影;血管造影术；支架;脑血管意外 　 ［摘要］ 目的 探讨数字减影血管造影（DSA）在缺血性脑血管病诊断中的应用价值及血管内支架的疗效、安全性和并发症。方法 分析我院2005年4月～2006年6月67例缺血性脑血管病患者临床与影像学资料，并对其中7例血管内支架术进行综合评价。支架植入术病例2例为颈动脉起始部狭窄，2例为椎动脉起始部狭窄，另3例为优势椎动脉颅内段狭窄。 结果 彩超、TCD、MRA资料显示：存在动脉粥样硬化斑块63例，存在严重血管狭窄（狭窄率gt;50%）5例； DSA资料显示：存在动脉粥样斑块的53例，存在严重血管狭窄的13例，Moyamoya病1例，基底动脉梭型动脉瘤1例。行支架植入的患者除1例手术径路差而中止手术，其余6例手术均获得技术上的成功，取得良好的效果，随访3个月症状无复发。结论 对缺血性卒中患者行DSA检查可以明确有无血管狭窄、明确病因，并有利于对血管内支架植入术进行风险－效益评估。而血管内支架植入术可能会改善患者的预后，近期疗效好。 ［关键词］ 数字减影;血管造影术；支架;脑血管意外 Study of application of DSA and endovascular stentassisted angioplasty in patients with ischemic cerebrovascular disease ［Abstract］ Objective To study both the value of digital subtraction angiography （DSA） and the efficacy,the safety and the complicated symptoms of endovascular stenting in the diagnosis and the treatment of ischemic stroke. Methods The clinical and imaging meterials of 67 cases of ischemic stroke were analysed. In these cases, endovascular stenting was performed in 7 patients: 2 stenosis of internal carotid origin, 2 stenosis of the dominant vertebral artery origin, and 3 stenosis in the intracranial segment of the dominant vertebral artery. Results ColourDoppler ultrasound, TCD and MRA demonstrated that atherosclerosis plaques in 63 patients, severe artery stenosis in 5 patients. DSA demonstrated that atherosclerosis plaques in 53 patients, severe artery stenosis in 13 patients, moyamoya disease in 1 patient and fusiform aneurysm in 1 patient. In the stentplanted cases, the stent failed to reach the intracranial vertebral artery with stenosis in 1 patient because of the tortuous path of the artery. Stenting was successful in the other 6 patients. No serious complications occurred. Followup for 3 months showed smooth postoperative courses. Conclusion To the ischemic stroke, DSA may not only find the vascular stenosis and the cause of disease but also help to value the profit and venture of endovascular stenting. Endovas