脑血管介入诊疗术后患者随访观察

Follow-up study in patients after cerebral intravascular intervention

目的评估脑血管介入治疗中长期临床疗效。方法对378例进行脑血管介入诊疗术的患者进行前瞻性综合分析。结果41例脑动脉狭窄患者行血管内支架成形术,随访期内病死率为2.4%(1/41);术后仍有部份临床症状和体征13例次,再狭窄率为10%,无出血和缺血性卒中事件发生;51例未行支架治疗,随访期内缺血性卒中发生率为7.8%(4/51),病死率为5.9%,血管狭窄加重率为43.5%;16例动脉瘤患者实施弹簧圈栓塞术,术后仅2例仍有轻微头痛,无出血性卒中发生;11例动脉瘤未栓塞者,观察期内再出血率27.3%,病死率9.1%;4例脑动静脉畸形(AVM)患者弹簧圈加氰基丙烯酸正丁酯(NBCA)凝胶栓塞术,术后再出血1例发生率为25%。结论严格掌握颈动脉内支架成形术指征,术后中长期疗效仍令人满意;对符合介入指征的动脉瘤和AVM患者,应积极进行栓塞治疗。

Objective The purpose is to assess long-term efficacy, safety and outcomes of cerebral Intravascular treatment. Methods Retrospective analysis of 378 patients underwent intravascular diagnosis and treatment was performed. Results 41 patients with cerebral artery stenosis underwent cerebral artery stenting procedures, of which death rates is 2.4% ; 13 cases patients have neurological signs and symptom, the recurrence rate is 10% with no stroke events happened. However the stroke rate is 7.8% in 51 patients without intravascular intervention during Follow-up period and the death rates is 5.9% , and about 43.5% patients＇ artery stenosis become worsening. There were 16 patients with cerebral aneurysms treated with coiling procedure of which only 2 patients have mild-headache and no bleeding event happen during Follow-up period; but the re-bleeding rate is 27.3% and death rates is 9. 1% in 1 l patients without coiling proeeduee. 4 AVM embolized by coil and NBCA with the re-bleeding one case. Conclusions For suitable patients, cerebral artery stenting is a safe procedure and the mid and long-term outcomes are satisfactory. Intravascular embolization works successfully both in aneurysms and AVM cases.