锁骨下动脉盗血综合征的临床特点与血管内支架治疗

Clinical characteristics and endovascular stents treatment in patients with subclavian steal syndrome

目的探讨锁骨下动脉盗血综合征(subclavian steal syndrome,SSS)的临床特点以及血管内支架治疗的效果。方法回顾15例行血管内介入治疗的SSS患者的临床表现、颈部血管超声、数字减影血管造影(DSA)等相关资料及血管内支架置入情况,分析其临床特点及血管内支架置人的疗效。结果 (1)临床疗状中以头晕最常见,共12例(80.0%),体征中以锁骨上区血管杂音最常见,共12例(80.0%)。(2)15例患者中左侧锁骨下动脉狭窄8例,闭塞4例;右侧锁骨下动脉重度狭窄3例,左侧椎动脉重度狭窄1例。15例患者成功置入血管内支架16枚,其中15枚为锁骨下动脉支架,1枚为椎动脉支架。术后同侧上肢脉搏、血压恢复;随访3～41个月,再狭窄发生率低。结论 SSS最主要的临床表现为椎-基底动脉供血不足的症状和体征,血管内支架置入可有效缓解其临床症状。

Objective To investigate the clinical characteristics and evaluate the effects of endovascular stents in patients with subclavian steal syndrome （SSS）. Methods Clinical manifestations, cervical vascular ultrasound, digital subtraction angiography （DSA） and other relevant information of the endovascular stent treatment were collected among 15 SSS cases with endovascular treatment. And the clinical features and effect of endovascular treatment were analyzed. Results （1） The most common symptom was dizziness （12 cases, 80.0%）. The most common sign was murmur from the subclavian artery （12 cases, 80.0%）. The risk factors included hyperlipemia, hypertension, diabetes mellitus, cigaritte smoking and alcohol consumption. （2） The left subclavian artery stenosis （8 patients） and occlusion （4 patients）, the right subclavian artery stenosis （3 patients） were observed by DSA. 16 stents were placed successfully in 15 patients, and 15 stents were performed for the subclavian artery, and 1 stent for the vertebral artery as results of the vertebral artery stenosis at the same time. The pulses and blood pressure of the arms recovered immediately. During the 3-41 months follow-up, restenosis occurred in 1 patient 3 months later. Angioplasty was performed and the artery remained patency in 20 months. Conclusions The most common clinical manifestation in the SSS was coincident with the features of the vertebro-basilar artery insufficiency. Endovascular stent was effective for patients with SSS.