非优势侧椎动脉缺血性病变的介入治疗

Interventional treatment of ischemic cerebrovascular disease associated with non-dominant vertebral artery

目的回顾性研究非优势椎动脉缺血性病变的介入治疗方法,探讨该类病变治疗的必要性与有效性。方法对我科收治的以后循环缺血症状为主的10例患者进行回顾性分析,其中男性8例,女性2例(平均年龄52岁),所有患者均接受DSA检查并确诊为非优势侧椎动脉为责任病变血管。结果 4例患者在病变血管植入5枚Wingspan支架,4例患者在病变血管植入5枚Apollo支架,2例患者在病变血管植入2枚SD支架。术后6个月DSA随访结果显示2例患者出现支架内轻度再狭窄;8例患者无支架内再狭窄。所有患者均无临床缺血症状出现。结论对非优势侧椎动脉狭窄或夹层引起的缺血性表现建议积极处理;对无症状的非优势侧椎动脉病变需要DSA检查,评估该侧病变进展后可能导致的潜在风险,进行个体化治疗或单纯随访。

Objective To retrospectively study the necessity and efficacy of interventional treatment for ischemic cerebrovascular disease associated with non-dominant vertebral artery. Methods Ten patients（including eight males and two females,averaged 52 years old）who were diagnosed as arteriostenosis or dissection were retrospectively studied.All the patients underwent angiography and the non-dominant vertebral artery was confirmed as the responsible vessel.Results Five Wingspan stents were deployed in four patients and five Apollo stents were deployed in the other four. And two SD stents were deployed in the rest two. Six months later,there were two patients were found light in-stent stenosis on DSA（digital subtract angiography）. The residual stenosises were absolutely eliminated in eight patients. None of the patients were found with ischemic symptoms. Conclusions Our study suggests that arteriostenosis or dissection in the non-dominant vertebral artery should be treated by stenting. DSA should be performed in non-dominant vertebral artery disease in order to evaluate the potential risk. Treatment or follow up alone should be adopted individually for this kind of patients.