支架成形术治疗后循环缺血86例疗效观察

Stenting in Posterior Circulation Ischemia: A Clinical Analysis of 86 Cases

目的评价支架成形术治疗因大血管病变引起的后循环缺血的疗效及安全性。方法回顾分析我科2003年3月以来开展的支架成形术治疗因大血管病变引起的后循环缺血患者的疗效及随访结果。86例患者进入研究,其中男性58例,女性28例,平均年龄61±5岁。结果86例患者中2例为左椎动脉V3段夹层动脉瘤所致,1例为左椎动脉开口处夹层所致的狭窄,其余83例患者为动脉粥样硬化血管狭窄所致;2例手术失败,手术成功率97.7%。平均随访22.5±10.5个月。随访期间发生前循环脑梗死4例;后循环脑梗死3例,TIA2例,后循环缺血性卒中发生率为5.95%;脑出血2例。随访期间死亡3例,占3.57%。结论支架成形术可有效治疗椎-基底动脉狭窄与夹层动脉瘤,预防缺血性脑血管疾病的发生。

Objective To evaluate the effects and safety of stenting for posterior circulation ischemia resulted from large artry occclusive diseases. Methods Patients of posterior circulation ischemia resulted from large artry occclusive diseases were treated with stenting since March, 2003 in our hospital, and we took a retrospective study on the effects and follow-up results. Total 86 patients enrolled in our study, 58 males and 28 females, mean age 61±5 year. Results Among the 86 patients, two cases were resulted by dissecting aneurysm of V3 segment of left vertebral artery, one case was resulted from dissecting stenosis of the origin of left vertebral artery and 83 cases were resulted from atherosclerotic artery stenosis. The successful rate of stenting was 97.7%. After 22.5±10.5 months follow-up, we found 4 cases of anterior circulation infarct, 3 cases of posterior circulation infarct, 2 cases of posterior circulation transient ischemia attach(TIA), 2 cases of cerebral hemorrhage and 3 cases of death. The incidence rate of ischemic accidents in posterior circulation was 5.95%. Conclusion Stenting may be an effective therapy in the management of stenosis and dissecting aneurysm of the vertebrobasilar artery, and it can prevent posterior circulation ischemia.