双微导丝技术用于径路血管极度迂曲的症状性大脑中动脉狭窄支架成形术

Double Micro-wire Technique in Angioplasty with Stent for Symptomatic Middle Cerebral Artery Stenosis with Extremely Tortuous Access Vessel

目的 报道使用双微导丝技术成功地完成 2例症状性大脑中动脉 (MCA)狭窄支架成形术的经验。方法 2例患者临床上均以半球短暂脑缺血发作 (TIA)为特征 ,血管造影证实大脑中动脉(MCA)主干 (M1段 )狭窄伴同侧颈内动脉 (ICA)虹吸段极度迂曲。均首先采用常规技术 ,在支架通过失败后 ,改用双导丝技术。结果 2例支架均较为顺利地到达靶病变 ,定位准确 ,扩张满意 ,远端前向血流明显改善 ,残余狭窄分别为 0 %和 10 %。围手术期无任何并发症发生 ,短期随访无缺血事件发作。结论 在颅内支架成形术中 ,双微导丝技术是克服径路血管迂曲的一种方法。

Objective To report our experience of successful stenting of middle cerebral artery (MCA) stenosis using a double micro-wire technique.Methods In two patients, the clinical picture was characterized by hemispheric transient ischemic attacks (TIAs), and cerebral digital subtraction angiography (DSA) revealed a stenosis of the MCA main trunck (M1 segment) associated with extremely tortuosity of the ipsilateral internal carotid artery (ICA) siphon. Both patients were eventually treated with intracranial stent placement using a double micro-wire technique after initial failed attempts using standard techniques. Results In both patients, the stents were correctly placed with satisfactory dilatation and good distal forward flow established. There was no residual stenosis in 1 patient and about 10% of residual stenosis in another. They had no any complication during and after the procedure. There have been no any ischemic events in both patients during a short-term follow up.Conclusions Double micro-wire technique is a safe and effective method at overcoming the tortuous access vessel for intracranial stenting.