症状性颅内动脉狭窄血管内支架成形术的疗效观察

Therapeutic effect observation of endovascular stent assisted angioplasty for symptomatic intracranial arteriostenosis

目的观察症状性颅内动脉狭窄患者血管内支架成形术的疗效和安全性。方法对4例症状性颅内动脉狭窄患者行血管内支架成形术,通过临床症状、数字减影血管造影(DSA)、经颅多普勒(TCD)评价其疗效,并随访7～10个月。结果4例患者手术全部成功,术后即刻造影显示狭窄程度明显改善,平均狭窄程度从术前的75%下降到8.0%。术中发生短暂性抽搐1例,无脑栓塞及颅内出血等并发症。术后随访7～10个月,未见新的TIA或脑梗死,TCD复查未见再狭窄。结论血管内支架成形术是治疗症状性颅内动脉狭窄的一个相对安全、有效的手段。

Objective To observe the effectiveness and safety of endovascular stent assisted angioplasty for symptomatic intracranial arteriostenosis. Methods 4 patients with symptomatic intracranial arteriostenosis were treated with endovascular angioplasty using balloon expandable stents. Therapeutic effects were evaluated by clinical manifestations, digital subtraction angiography （DSA） and transcranial Dopple （TCD） before and after the operation. Follow up was made for 7-10 months. Results Technical success was achieved in all patients, with no complication of cerebral embolism and hemorrhage except one of transient seizure during operation. Angiographic results immediately after stenting suggested that the residual postoperation stenosis was 8% （ 0%-17% ）, with significant reduction from preoperation stenosis of 75% （70%-80. 7% ）. No recurrent TIA and stroke occurred and no restenosis was found with serial TCD in all 4 patients during follow up of 7-10 months. Conclusions Endovascular stenting is a safe and effective therapeutic tool for symptomatic intracranial arteriostenosis.