椎-基底动脉重度狭窄的血管内治疗

Endovascular treatment of severe vertebrobasilar artery stenosis

目的回顾性分析椎-基底动脉重度狭窄患者临床诊断与治疗经过,以评价血管内支架成形术的可行性和临床疗效。方法16例椎-基底动脉重度狭窄患者均施行血管内支架成形术,观察其技术成功率、围手术期并发症发生率及远期疗效。结果16例患者经脑血管造影检查共发现27个狭窄病变,共成功植入36枚球囊扩张式支架,技术成功率达100%(16/16)。1例于手术后24h发生支架内急性血栓形成,围手术期并发症发生率为6.25%(1/16)。随访期间,3例(18.75%)发生支架内再狭窄而致卒中再发。结论血管内支架成形术治疗椎-基底动脉重度狭窄,在技术上可行,远期疗效良好。

Objective To retrospectively analyse the clinical diagnosis and treatment of patients with severe vertebrobasilar artery stenosis and to evaluate the feasibility and clinical effectiveness of stent-assisted angioplasty. Methods Sixteen patients with severe vertebrobasilar artery stenosis were treated by stent-assisted angioplasty. Technical success rate, perioperative complication rate and long-term follow-up result were evaluated. Results In 16 patients 27 stenotic lesions were found by cerebral angiography. A total of 36 balloon-mounted stents were successfully implanted. The technical success rate was 100% （16/16）. Mter 24 h-operation, one patient occurred in-stent aucte thrombosis, the perioperative complication rate was 6.25% （1/ 16）. During the follow-up period, 3 patients （t8.75%） had recurrence of stroke due to in-stent restenosis confirmed by cerebral angiography or transcranial Doppler （TCD）. Conclusion Stent-assisted angioplasty is a feasible technical method for the treatment of severe vertebrobasilar ;artery stenosis, and the long-term effect is good.