血管内支架成形术治疗糖尿病性脑动脉狭窄21例

Stent-assisted Angioplasty for the Treatment of Diabetic Cerebral Artery Stenosis:a Report of 21 Cases

目的探讨糖尿病性脑动脉狭窄血管内支架植入术的基本方法。总结21例治疗经验及并发症的发生与防治。方法21例脑动脉狭窄患者行腔内支架成形术,共植入支架30个,其中锁骨下动脉3个,颈总动脉3个,颈内动脉起始部12个,颈外动脉1个,大脑中动脉3个,椎动脉8个,应用脑保护装置16只。结果21例支架全部置入成功,18例狭窄减少>80%。3例减少>70%。16例脑保护装置均成功释放及回收,4例患者术中出现急性血栓形成,经救治恢复。结论经皮血管内支架成形术是治疗糖尿病性脑动脉狭窄新的有效方法,在严格掌握适应证和有经验的医生操作下,治疗是安全的。使用脑保护装置可明显减少神经系统并发症。

Objective To investigate the basic methods of the stent-assisted angioplasty for the treatment of diabetic cerebral artery stenosis. Summarize therapy experiences,occurrence and prevention and cure of complications. Methods The procedures of stent-assisted angioplasty were performed in 21 patients with severe cerebral artery stenosis. Thirty stents were implanted,among which 3 were in subclavical artery, 3 in common carotid artery112 in initiation paragraph of carotid artery, 1 in external carotid artery, 3 in middle cerebral artery, 8 in vertebral artery. 16 of these patients were operated under cerebral protection. Results Stents were successfully implanted in all patients,the degree of stenosis reduced more than 80% in 18 patients and 70% in 3 patients. Sixteen filter devices for cerebral protection were used successfully. During periprocedural period,4 patients had acute thrombogenesis and recovered after remedy. Conclusion Endovascular stenting angioplasty is a new and effective technique in treatment of diabetic cerebral artery stenosis, and will be safe if indications are strictly performed and procedures are operated by experienced doctors. Complications of nervous system are obviously decreased by using cerebral protection device.