颅内动脉狭窄血管内支架成形术的价值研究

The value of endovascular stent-assisted angioplasty for the treatment of symptomatic intracranial artery stenosis

目的研究对严重颅内脑动脉狭窄进行血管内治疗的可行性和安全性。方法34例症状性颅内脑动脉狭窄患者接受了血管内支架成形术。结果本组MoriA型病变29例,B型病变5例;狭窄位于大脑中动脉12例、大脑前动脉1例、颅内颈内动脉1例、颅内椎-基底动脉20例。在内支架成形术后,平均动脉狭窄率从70.9%下降到9.0%(P<0.01)。在围手术期内,除1例(左椎动脉V3段串联病变)发生蛛网膜下腔出血死亡外,余无严重并发症发生。存活的33例平均随访18个月(3～36个月),未发生缺血性神经事件。结论血管内支架成形术是治疗部分严重颅内脑动脉狭窄安全、有效的方法。

Objective To study the efficacy and safety of the treatment of symptomatic intracranial artery stenosis with endovascular stent-assisted angioplasty. Methods The endovascular stent-assisted angioplasty was performed in 34 patients with symptomatic intracranial artery stenosis. Results In all patients, Mori type A and B lesions were detected in 29 and 5 cases respectively, and the stenosis in MCA, ACA, intracranial ICA and intracranial VBA were found in 12,1,1 and 20 cases respectively. After successful endovascular therapy, the average degree of stenosis was significantly improved from 70. 9% to 9. 0% （P 〈0.01 ）. There were no serious complications during the periprocedural period, except one who had tandem stenosis of V3 paragraph of left vertebral artery and got SAH after succesful stent-assisted angioplasty and died later. Within mean 18 months＇ follow-up （ ranged from 3 months to 36 months）, there were no episodes of ischemic neurological events in 33 survivors. Conclusions Endovascular stent-assisted angioplasty is effective and safe for the treatment of some severe intracranial artery stenosis.