锁骨下动脉窃血综合征的经皮血管内成形术及内支架治疗

Application of PTA and stent in the treatment of subclavian steal syndrome

目的研究经皮血管内成形术（ＰＴＡ）及内支架治疗锁骨下动脉窃血综合征的疗效。方法应用ＰＴＡ及内支架置入技术，治疗６例锁骨下动脉窃血综合征患者。结果６例造影显示锁骨下动脉有不同程度的狭窄（２条血管）或闭塞（４条血管），均有窃血表现。４例经用导丝引导顺利完成ＰＴＡ治疗。２例分别给予置放Ｗａｌｓｔｅｎｔ及Ｐａｌｍａｚ支架，患者在治疗后脉搏搏动恢复，临床症状消失，造影显示血管及支架恢复通畅，１周后康复出院，近期疗效十分满意。１例随访６年，２例分别随访５年、１年，未见复发，１例随访３年后出现再狭窄，２例随访３个月未见复发。结论ＰＴＡ及内支架治疗锁骨下动脉窃血综合征安全可行，操作简单，创伤小，预后佳，是一种较理想的治疗方法。

Objective To study the clinical effect of percutaneous transluminal angioplasty(PTA) and stent in the subclavian artery steal syndrome. Methods To analyze the clinical results of using PTA and stent to treat 6 patients with subclsvian steal syndrome. Results Angiography showed that in all patients the subelavian arterles were obstructed in different degree, and steal syndrome was demonstrated. 4 patients were treated with PTA, stents was used in 2 patients. After the treatment , the pulse recovered and the syndrome disappeared. Postoperative angiography showed the artery became patent and, the patients were discharged from the hospital in a week in good clinical condition. 3 patients were followed for 1,5 and 6 years without recurrence of symptoms. Obstruction was demonstrated in another case 3 years after the procedure. Conclusions PTA with stent placement is a good method to treat subclavian steal syndrome. It is safe, easy to perform with minimal invasiveness and good clinical results.