大动脉炎性脑缺血血管内介入诊疗

Angiographic diagnosis and interventional therapy for cerebral ischemia due to Takayasu arteritis

目的探讨大动脉炎性脑缺血的血管造影诊断与介入治疗价值。方法18例大动脉炎患者行血管造影检查。由有经验的介入放射学医师按盲法对其血管造影及介入治疗资料进行回顾性分析,然后共同讨论并达成一致意见。结果18例中,经血管造影按Lupi-Herrera综合分型法Ⅰ型16例,Ⅲ型2例。主要受累动脉包括锁骨下动脉17例,颈动脉15例,椎动脉10例,头臂干5例。8例行经皮腔内血管成形术和支架置入术均获成功。结论血管造影有利于大动脉炎性脑缺血的临床诊断与指导治疗,血管内介入治疗是一种微创的疗效可靠的治疗手段。

Objective To explore the value of angiographic diagnosis and interventional therapy for cerebral ischemia caused by Takayasu arteritis. Methods Eighteen patients with Takayasu arteritis（TA） underwent angiography were analyzed retrospectively. The angiographic appearances in all of the patients were observed dynamically in a double blind metnoa by two experienced radiologists together and formed a consensus interpretation. Results According to the classification of Lupi-Herrea,type Ⅰ was found in 16 eases,type Ⅲ in 2 eases by angiography. Among 18 patients the arterial involvement included subclavian artery in 17 cases, carotid artery in 15 cases, vertebral artery in 10 eases, brachiocephalic trunk in 5 cases. Percutaneous transluminal angioplasty and the stent placement were managed in 8 cases successfullly. Conclusion Angiography is one of the ideal and reliable methods for the diagnosis and guidance of the interventional treatment for cerebral ischemia due to Takayasu arteritis, and the latter is a mini-invasive and effective way for cerebral ischemia due to Takayasu arteritis.