血管腔内支架成形术治疗椎动脉狭窄

Observation of Endovascular stent Angioplasty in the Treatment of Vertebral Artery Stenosis

目的 探讨支架成形术治疗椎动脉狭窄的安全性及有效性。方法 选取我院神经内科收治的48例以后循环缺血症状为主要表现的椎动脉狭窄的患者,狭窄率≥70%,应用药物治疗无效,给予支架进行治疗。术后1、6、12、36个月进行随访,DSA或CTA及MRA对支架置入患者进行随访,观察再狭窄率、术后用药情况、缺血复发事件及并发症情况。结果 48例患者的48处重度狭窄均成功置入支架,成功率100%。术前狭窄率75%~90%,平均为（79.85）%;术后狭窄率0~10%,无手术并发症。术后随访3~36个月,一例再发后循环缺血事件。随访DSA,支架内轻度再狭窄1例。术后Malek评分中1月1分者48例,6月1分42例、而2分者为6例;12月1分32例、2分者8例,36月1分18例、2分者4例。结论 经皮血管内支架成形术治疗椎基底动脉狭窄安全、有效,合并症少,中短期疗效明显。

Objective Discuss the safety and effectiveness of stent angioplasty in the treatment of vertebral artery stenosis. Methods In our hospital in the department of neurology,48 cases after circulation ischemia symptoms as the main manifestation of vertebral artery stenosis patients,stenosis rate is greater than or equal to 70%,invalid application of drug therapy and received stents for treatment. 1,6,12,36 months after operation,DSA or CTA and MRA were followed up. The restenosis rate,postoperative medication,ischemic recurrence and complications were observed. Results 48 cases of patients with severe stenosis of the successful placement of the stent,the success rate of 100%. The stenosis rate was 75% to 90%,and the average was（ 79. 85） %; the stenosis rate was 0 to 10%,and no complication was in operation. The patients were followed up for 6 to 36 months,and one case of recurrent ischemic events. Follow up of DSA,1 cases of mild stenosis in the stent. Malek score of 48 cases,1 cases in June,2 points in 42 cases,and 2 points were 6cases; in December,1 points in 32 cases,8 cases,36 cases,18 cases,2 cases,4 cases,1 cases. Conclusion Percutaneous endovascular stenting is safe and effective in the treatment of vertebral basilar artery stenosis,with less complications and obvious short-term effect.