106例缺血性脑血管病患者全脑血管造影分析

DSA results of 106 patients with ischemic cerebrovascular diseases

目的分析缺血性脑血管病患者颅内外动脉狭窄的分布。方法对我院实施DSA检查的106例缺血性脑血管病的结果进行分析,均经头颅CT排除脑出血,TCD及颈动脉彩超检查后怀疑有动脉狭窄的缺血性脑血管病。所有患者均实施选择性全脑血管造影术,椎动脉和颈动脉均有正侧位血管造影像;根据患者的DSA检查结果,分析动脉狭窄的部位、受累血管数目及血管狭窄形态;重度狭窄的病例予以支架治疗和球囊成型术。结果血管造影结果提示89.6%患者有不同程度的血管狭窄或闭塞,其中75.5%为前循环受累,37.7%为后循环受累。前循环受累血管中以颈内动脉(56.6%)和大脑中动脉(26.4%)受累最常见,后循环受累血管中以椎动脉(33.0%)最多见。支架治疗和球囊成型术临床疗效显著。结论缺血性脑血管病造影显示大部分患者有肯定的脑血管狭窄和闭塞。脑梗死患者血管病变以颈内动脉病变为主,椎基底动脉供血不足亦以颈内动脉病变多见,支架治疗和球囊成型可作为重度狭窄的治疗方法。

Objective To analyze the distribution of the intracranial and extracranial arteriostenosis in patients with ischemic cerebrovascular diseases（ICVD）. Methods The 196 cases suffered from ICVD should be excluded cerebral hemorrhage by CT scan, tested by TCD and color Doppler suspected arteries stenosis. All subjects underwent high selective angiographies. If want,carotid arteries,vertebral, and all the in tracranial arteries. The degree of stenosis, by the patient resurlt of DSA, the localization and numbers of the arterise involved and the morphology of plague or the stenosis were assessed. Results The result of angioplasty showed occlusive findings of cerebral arteries in 94% of the patients, among them 76% were located in anterior circulation and 24% were located in posterior. Additional 9 symptomatic occlusive were found. Angiograms were normal in 6%. The internal carotid and middle cerebral arteries were most frequently involver in this series. The vertebral arteries are the most commonly involved in the posterior circulation. 5cases of Moyamoya＇s disease,2 cases of cerebral vascular malformations,2 cases of taksyasu arteritis. Conclusion Most of the patients with ischemic cerebrovascular disease are dovumented with definitive occlusion of the cerebral arteries. The options of treatment should be based on the morphology of the involved arteries. Interventional neuropathology is useful for ischemic cerebrovascular disease.