支架置入术治疗锁骨下动脉狭窄/闭塞合并相邻椎动脉起始部狭窄病变——回顾性病例系列分析和随访

Stenting for patients with subclavian artery stenosis/occlusion and adjacent stenosis at the origin of vertebral artery:a retrospective case series analysis and follow-up results

目的探讨血管内支架治疗锁骨下动脉狭窄/闭塞合并相邻椎动脉起始部狭窄病变患者的疗效。方法回顾性分析接受血管内支架治疗锁骨下动脉狭窄/闭塞合并相邻椎动脉起始部狭窄病变患者的临床资料,包括人口统计学特征、血管危险因素以及支架治疗和随访。结果共纳入28例锁骨下动脉狭窄/闭塞合并相邻椎动脉起始部狭窄病变患者,其中男19例,女9例,平均年龄(65±9)岁。总的技术成功率为92.9%,其中锁骨下动脉狭窄合并相邻椎动脉起始部狭窄23例(82.1%),锁骨下动脉闭塞合并相邻椎动脉起始部狭窄5例(17.9%),有2例发生并发症,无介入相关的严重脑卒中和死亡。平均随访(24±18)个月,发生再狭窄3例和临床相关事件5例。术后12、24个月和随访结束时首次血管通畅率分别为92.4%、82.5%和78.8%,无临床相关事件存活率分别为92.5%、78.6%和70.5%。结论血管内支架可安全和有效地治疗锁骨下动脉狭窄/闭塞合并相邻椎动脉起始部狭窄的患者。

Objective To investigate the efficacy of endovascular stenting on the patients with subclavian artery stenosis/occlusion and adjacent stenosis at the origin of vertebral artery. Methods The clinical data of the patients with subclavian artery stenosis/occlusion and adjacent stenosis at the origin of vertebral artery who receiving endovascular stenting therapy were analyzed retrospectively, including demographic characteristics, vascular risk factors, as well as stenting for subclavian artery stenosis/occlusion and adjacent stenosis at the origin of vertebral artery and follow-up results. Results A total of 28 patients with subclavian artery stenosis/occlusion and adjacent stenosis at the origin of vertebral artery were enrolled in the study, 19 of them were males and 9 were famales （mean age of 65 ± 9 years）. The overall technical success rate was 92. 8%, among which the patients with subclavian artery stenosis were 82. 1% （n = 23）, and adjacent stenosis at the origin of vertebral artery and with subclavian artery occlusion were 17. 9% （n = 5）. The complications occurred in 2 patients. There were no intervention-related serious stroke and death. Mean follow-up was 24 18 months, 3 patients with restenosis and 5 with clinically relevant events were found. The first angioplasty patency rates were 92. 4%, 82. 5% and 78. 8% respectively at 12, 24 months after procedure and at the end of follow-up. The survival rates of no clinically relevant events were 92. 5%, 78.6% and 70. 5%, respectively. Conclusions Endovascular stenting can safely and effectively treat the patients with subclavian artery stenosis/occlusion and adjacent stenosis at the origin of vertebral artery.