血管内支架成形术治疗症状性椎动脉狭窄

Stent-assisted angioplasty for symptomatic vertebral artery stenosis

目的探讨血管内支架成形术治疗老年症状性椎动脉狭窄患者的长期疗效。方法对22例经药物治疗无效的老年症状性椎动脉狭窄患者行血管内支架成形术治疗，分析其技术成功率、围手术期并发症发生率及远期疗效。结果22例患者共植入24枚球囊扩张式支架，技术成功率达100％，平均狭窄率从（82．5±9．2）％降至（3．7±3．5）％（P〈0．01），围手术期内无严重并发症发生，临床随访27～58个月（平均42．6个月），2例患者出现症状复发，1例患者新发无症状小梗死，其余患者无脑缺血性事件发生，效果良好。结论血管内支架成形术是治疗老年症状性椎动脉狭窄的一种安全、有效的方法，远期疗效良好。

Objective To study the long outcomes of stent-assisted angioplasty （SAA） in the treatment of symptomatic vertebral artery stenosis in the elderly. Methods SAA was performed in 22 elderly patients with symptomatic vertebral artery stenosis that were response to medical treatment. The success rate, perioperative complications and long-term effec- tiveness were evaluated. Results A total of 24 balloon expandable stents were implanted in these patients. The success ratio was 100%. The degree of stenosis decreased from （ 82.5 ± 9.2） % to （ 3.7 ± 3.5 ） % （ P 〈 0.01 ）. Complications were absent during the perioperative period. Follow up was 27 -58 months （median：42.6 months）. Two patients devel- oped the recurrent symptoms of vertebral artery stenosis, one patient was found asymptomatic lacunar infarction newly and no cerebral ischemic events were noted in the remaining patients, suggesting favorable outcome. Conclusion SAA is a safe and effective strategy for the treatment of symptomatic vertebral artery stenosis in the elderly, the long outcome is fa- vorable.