锁骨下动脉狭窄的经皮血管球囊成形术及内支架治疗

Application percutaneous transluminal angioplasty and stent in the treatment of subclavian artery stenosis

目的 评价并比较经皮血管球囊成形术及内支架治疗对动脉粥样硬化及大动脉炎所致锁骨下动脉狭窄梗阻性病变的治疗效果。方法 13例锁骨下动脉狭窄梗阻性病变患者 ,病因为动脉粥样硬化 7例 ,大动脉炎 6例。其中锁骨下动脉狭窄 8例 ,完全闭塞 5例 ,均实施了介入治疗。 6例单纯行经皮血管球囊成形术 ,6例置入血管内支架 ,1例介入治疗失败。结果 12例行经皮血管内成形术 (PTA)或血管内支架置入治疗获成功 ,6例分别置入Strecker支架 (1例 )、Palmaz支架 (2例 )及Jostent血管内支架 (3例 )。介入治疗后血管恢复通畅 ,患者临床症状消失。 1例完全梗阻者因导丝未能通过病变 ,介入治疗失败。 12例介入治疗成功者随访 3～ 2 4个月 ,无一例发生再狭窄。结论 PTA及内支架治疗动脉粥样硬化及大动脉炎所致锁骨下动脉狭窄梗阻性病变 。

Objective To evaluate and compare the therapeutic results of subclavian artery angioplasty and stenting in patients with aortoarerteritis and atherosclerosis. Methods 13 cases (9 males and 4 females; age, 28-69 years) of subclavian artery stenotic occlusive disease were performed with PTA and stent. Results Six patients had aortoarerteritis, 7 had atherosclerosis lesions. Twelve of 13 stenoses could be successfully angioplasty ( n =6) and stenting ( n =6) . The one failure was due to the inability to cross the lesion with the guidewrie. Compared with atherosclerosis, higher balloon inflation pressure was required to dilate the lesions of aortoarerteritis. 12 patients were asymptomatic after PTA and stent implatation. Patients were follow up for 3-24 months and clinical examination demonstrated patency of the vessels with PTA and stents. Conclusion Subclavian PTA and stent implatation is safe and good clinical result as in aortoarerteritis as in atherosclerosis.