血管内支架成形术治疗症状性颅内动脉狭窄

Endovascular Stenting for Symptomatic Intracranial Arteries Stenoses

目的 初步总结颅内动脉狭窄血管内支架成形术的疗效及其治疗经验。方法 18例患者计19处颅内动脉狭窄(前循环11处、后循环8处)行球囊膨胀支架血管内成形术,术前平均狭窄(80.3±7.92)％,平均狭窄长度(5.89±1.82)mm。结果 19处动脉狭窄均成功支架植入,狭窄降至(4.68±9.53)％,无颅内出血、支架内急性闭塞手术并发症。短期随访(5～24个月)脑缺血症状均未再发作;脑血管造影随访15例,1例见支架内内膜增生但无再狭窄。结论 血管内支架成形术治疗颅内动脉狭窄是一种安全、有效的方法,但远期疗效还有待于进一步观察。

Objectives To evaluate the preliminary outcome of endovascular stenting for symptomatic intracranial arterial stenoses and to discuss our preliminary experienee. Methods Nineteen intracranial arteres stenoses (11 stenoses in the anterior circulation and 8 in the posterior) underwent endovascular angioplasty with balloon-expandable coronary stents in 18 patients with intracranial arteries stenoses. The average stenosis rate was (80.3±7.92)%, and the average length of the stenoses was (5.89±1.82)mm before the operation. Results The endovascular angioplasty was successful in all the 19 stenoses without complications relative to the operation. The average residual stenosis was (4.68±9.53)%. No recurrent transient ischemia attack and stroke were noted in all the patients during clinical follow-up (5-24 months after the stenting). FoLlow-up angiogram in 15 patients revealed no restenosis, though there was the mild endothelial hyperplasias in 1 patient. Conclusions Endovascttlar stenting for symptomatic intracranial arterial stenosis is safe, reliable, and effective. It is necessary for the long-term efficacy to be further observed.