后循环缺血介入治疗50例临床分析

Interventional Therapy of Posterior Circulation Ischemia:A Clinical Study of 50 Cases

目的分析50例后循环缺血病人脑血管造影表现、血管内治疗方法及治疗效果。方法短暂性脑缺血发作(TIA)25例,梗死组25例,根据造影显示的血管病变情况行选择性动脉溶栓或支架置入术治疗。结果TIA溶栓15例,1个月内再发2例,6个月后梗死1例;TIA支架10例,1个月内再发1例,6个月后无再狭窄发生。梗死溶栓25例,均取得明显疗效;支架治疗8例,6个月后无再狭窄发生。50例均无颅内出血等相关并发症或死亡发生。结论①采用动脉内溶栓及支架治疗后循环缺血具有较好疗效;②TIA应与急性脑梗死一样得到同等重视,积极检查和治疗;③中药可能在减少再灌注损伤以及减少支架后再狭窄方面发挥一定作用。

Objective To discuss the methods and clinical efficacy of interventional therapy for posterior circulation ischemia, Methods There were patients（pts） with TIA pts and 25 pts with stroke. According to the results of DSA, the received the therapy of selective in- tra-arterial thrombolysis（SIT） or percutaeous transluminal angioplasty（PTA）, Results 15 pts with TIA received the therapy of SIT, Two pts relapsed within one month. 1 case got stroke after 6 months. Tin pts with TIA received the therapy of PTA. One case relapsed within 1 month. All 25 pts with stroke received the therapy of SIT and got good curative effect. Eight pts cases received the therapy of PTA. There were no restenosis after 6 months and no procedural and peri - procedural complications, Conclusion The therapy of SIT and PTA was an effective method in the treatment of vertebrobasilar ischemia, attention to TIA like stroke. Chinese medicine might be probably useful to reduce hyperperfusion and restenosis.