单侧颈内动脉闭塞后侧支循环开放及其临床表现

Relationship between Collateral Circulation and Clinical Symptoms after Unilateral Carotid Artery Occlusion

目的：探讨在清醒状态下颅内动脉狭窄支架置入术的可行性及临床意义.方法：2007年2月到2008年1月,在局麻下应用血管内支架置入术治疗颅内动脉狭窄患者12例,其中颈内动脉系狭窄7例,椎-基底动脉系狭窄5例.结果：本组12例均成功接受了血管内支架置入,术中患者清醒,配合良好,无不良反应.术后6个月复查DSA提示,颅内动脉狭窄程度由原来的67.5%±9.5%下降至9.5%±2.8%（P＜0.01）.随访12～23个月,12例患者症状均改善,无卒中发生.结论：局麻下行血管内支架置入术治疗颅内动脉狭窄,可将重要并发症的危险性降到最低;颅内动脉痛觉神经并不敏感,完全可以承受介入支架置入操作.

Objective：To explore the relationship between collateral circulation and clinical symptoms of patients after unilateral internal carotid artery occlusion. Methods：According to the clinical manifestations, 54 patients with unilateral internal carotid artery occlusion diagnosed by digital subtraction angiography（DSA） examination were divided into three groups （ cerebral infarction, transient ischemic attack and asymptomatic group）. Results ：44 cases had collateral circulation out of 54 cases,including the anterior communicating artery （ ACOA ） open （ 38.9% ）, posterior communicating artery （ PCOA ） open （ 33.3 % ）, ophthalmic artery （ OA ） open （31.5% ）. The artery open cases with ACOA, PCOA and OA in cerebral infarc.tion group and transient ischemic attack group were less than those of asymptomatic group（ P 〈 0.05 ） , while the artery open cases in cerebral infarction group were markedly lower than those of transient ischemic attack group（ P 〈 0.05 ）, and the artery open cases of Willis circle open in asymptomatic group were significantly higher than those of in cerebral infarction group and transient ischemic attack group（P 〈 0.05 ）. Conclusions：The clinical symptoms are closely re- lated to collateral circulation alter unilateral carotid artery occlusion. ACOA open is better than OA and PCOA open in improving the clinical symptoms.