症状性椎基底动脉狭窄的血管内治疗（附95例报告）

Stent - assisted angioplasty for symptomatic vertebrobasilar artery stenosis

目的总结椎基底动脉系统症状性血管狭窄的血管内治疗的策略、方法、术中风险及术后疗效。方法回顾性分析2004年1月至2008年7月治疗的95例采用支架置入治疗的症状性椎基底动脉狭窄患者的临床资料。结果采用支架置入治疗的患者中，椎动脉起始部狭窄者21例，椎动脉颈段狭窄者3例，椎动脉颅内段狭窄者16例，椎基底动脉交界处狭窄者15例，基底动脉段狭窄者36例，大脑后动脉P2段狭窄者4例。所有狭窄均〉50％。手术的技术成功率为97％（92／95）。术后平均狭窄率从76．1％（50％～95％）下降到9．2％（0～20％）。所有患者均在术后6个月-2年内随访，其中88例患者效果良好。结论脑血管狭窄处支架置入术是目前治疗该类疾病的有效方法，其长期疗效还有待进一步观察。

Objective To summarize the experiences in endovascular stenting for vertebrobasilar artery stenosis, and to discuss its indications, technique, perioperative management, risk factor and postoperative effect. Methods Between January 2004 and July 2008, the transluminalstent-assisted angioplasty was performed in 95 patients with symptomatic vertebrobasilar artery stenosis. Results The locations of the stenoses were originated at vertebral artery 21 cases, vertebral artery carotid segment 3 cases ,vertebral artery intracranial segment 16 cases, joint of vertebral and basilar artery 15 cases, basilar artery 36 cases, posterior cerebral artery P2 segment 4 cases, All stenoses were more than 50%. The successful rate of stent implantation was 97% （92/95） without any serious complications. The degree of stenosis was significantly improved from 76. 1% to 9. 2%. During the follow-up, 88 cases there was no neurologic complication. Conclusions Preliminary results suggest that transluminal stent-assisted angioplasty in the treatment of verte-brobasilar ischemia to be a safe and effective. Long-term angiographic and clinical follow-up for monitoring a larger number of patients is needed.