介入治疗锁骨下动脉窃血综合征

Interventional treatment for subclavian steal syndrome

目的探讨锁骨下动脉狭窄或闭塞引起的锁骨下动脉窃血综合征(SSS)的介入治疗效果。方法回顾性分析15例锁骨下动脉狭窄(10例)或闭塞(5例)的患者资料。采用经股动脉顺行穿刺或经肱动脉逆行穿刺方式开通,行球囊扩张及支架植入术。术后观察患者体征及并发症。结果技术成功率为100%(15/15),术后患者症状、体征消失,双上肢收缩压差由术前的(47.00±19.30)mmHg下降至(5.33±2.32)mmHg,差异有统计学意义(P<0.05)。术后造影示椎动脉血流转为正向血流。随访1～4年,未发现再狭窄。结论介入治疗锁骨下动脉狭窄或闭塞性病变引起的SSS安全、有效。

Objective To assess the efficacy of interventional therapy for subclavian steal syndrome （SSS） caused by stenosis or complete occlusion of subclavian artery. Methods Fifteen patients （including 10 patients with stenosis and 5 with complete occlusion of sublavian artery） were analyzed retrospectively. Interventional managements included antegrade ap- proach recanalization via transfemoral arteries and retrograde approach recanalization via transbrachial arteries. Balloon dilatation and stent implantation were used for all the lesions. Symptoms and complications were observed after operation. Resuits The technical success rate of 15 patients was 100% （15/15）. After treatment, the symptoms and signs disappeared in all patients. The systolic blood pressure difference in both arms descended from （47. 00±19. 30）mmHg pre-procedure to （5.33±2. 32）mmHg post-procedure （P〈0.05）. Post-procedural angiography showed regained antegrade flow in vertebral arteries. No restenosis was found during 1--4 year＇s following up. Conclusion Interventional treatment is safe and effective for SSS caused by stenosis or complete occlusion of subclavian artery.