血管内支架成形术治疗椎动脉起始段狭窄疗效探析.docVIP

血管内支架成形术治疗椎动脉起始段狭窄疗效探析 分类号：R543. 5 A 1009_816X(2011)05_0341_04 D0I：10. 3969/j. issn. 1009一816X. 2011.05. 04 Clinical Study of Stentassistant Angioplasty for Treatment Stenosisof Vertebral Artery Origin. YAN Yong xing, LIANG Li zhen, CHEN Tao, et al. Department of Neurology, The 3 th hospital of Hangzhou, Zhejiang 310009, China [Abstract ] Objective To study the efficacy, security and feasi bility of stent_assistant angioplasty (SAA) in the treatment of vertebral arteryorigin stenosis. Methods The SAA was performed in 16 patients with symptomatic ve rtebral artery origin stenosis. Technical success rate, perioperative complicatio n and long_term follow_up results were evaluated. Results 16 flexible balloon expandable stents w ere implanted in 16 patients. Technical success rate was 100%, and the average s tenosis was reduced from (82. 44±8. 59)% to (4. 19±3. 23)%(P0. 01). No s erious compli cations happened in perioperative period. During the further clinical follow_upperiod from 3 months to 32 months (mean 20. 8 months), 2 patients had recurrenceof symptoms, and the remaining patients had good effect and had no cerebral isch emic events. Of which 2 patients had in_stent restenosis . Conclusions SAA was a safe and effective method for treatment ofsenile vertebral artery stenosis. [Key words ] Vertebral artery ； Stenosis Angioplasty； Stent 椎动脉起始段狭窄或闭塞是后循环缺血性卒中的重要 ，常规的药物治疗对于椎动脉狭窄患者常不能获得持 久疗效，预后较差［1,2］。近年来血管内支架成形术开始应 用于脑血管病的治疗，它对于重建血管路径，增加脑血流 量，降低卒中发病率有明显效果［3,4］。本文分析16例在 我院接受血管内支架成形术治疗椎动脉起始段狭窄患者的 疗效和随访结果。 1资料与方法 1.1 1.1 般资料：患者接受血管内支架成形术 （stent_assistant angioplasty, SAA）的适应症：（1）年铃 60岁；（2）症状性患者（椎基底动脉系统TIA或非致残性 缺血性卒中），临床DSA检查证实椎动脉狭窄率〉50%，合 并对侧闭塞；（3）症状性优势侧椎动脉狭窄率〉5 0%; （4） 症状性非优势侧椎动脉狭窄，但该侧椎动脉直接与小脑后下 动脉延续，患者症状与同侧小脑后下动脉区供血不足有关; （5）患者及/或家属同意接受SAA成形术，随访依从性好。 禁忌症：（1）中风后遗留严重的神经功能障碍；（2）合并心、 肝、肾、肺等器官严重疾患或功能衰竭；（3）血管完全闭塞; （4） 近3个月内有颅内出血或内脏出血，或目前有出血倾向； （5） 伴有颅内动脉瘤或动静脉畸形，并且不能提前或同时处 理者；（6）合并颅内肿瘤。 2008年5月至2011年1月期间在我科住院的症状性椎 动脉狭窄16例患者符合上述标准并接受SA A成形术，其中 男5例，女11例，年龄65?78（72. 56±4. 16）