症状性颅内动脉狭窄支架治疗围手术期并发症分析

Perioperative complications of stenting with symptomatic intracranial artery stenosis

目的分析症状性颅内动脉狭窄支架治疗患者围手术期并发症,探讨其发生机制及预防。方法收集广西脑卒中中心登记的症状性颅内动脉狭窄并行血管内治疗的患者共63例。记录所有入组患者年龄,是否高血压、糖尿病、高脂血症、抽烟以及并发症发生时间、类型。结果入组患者63例,1例患者因血管迂曲支架无法到位结束手术,1例患者因血管发生严重痉挛结束手术,手术成功率96.83%。61例患者共植入61枚颅内支架,发生围手术期并发症5例,发生率为8.20%(5/61),其中术后出血性卒中3例,缺血性卒中2例。2例患者死亡,死亡率3.28%。结论症状性颅内动脉狭窄支架治疗并发症发生率较高,术前充分评估、选择患者,术中仔细操作以及严格术后管理可以有效降低并发症的发生率。

Objective To investigate the perioperative complications of stenting with symptomatic intracra- nial artery stenosis and study the mechanism and prevention of complications. Methods 63 patients were collect- ed from Stroke Center of Guangxi. They were proved intracranial artery stenosis and performed intracranial stentsl Patients＇ age, with hypertension, diabetes and hyperlipidemia or not, smoking or not, types and occurrence time of complications were registered. Results 63 patients were registered and 2 patients terminated operation due to blood vessels circuity or serious vessel spasm. Operation success rate reached 96.83%. 5 patients had complications among 63 cases, with complication incidence of 8.20%. 3 patients experienced cerebral hemorrhage and two cere- bral infarction in peri- operation period. 2 patients died of complications and mortality rate was 3.28%. Conclu- sions The incidence rate of complications of intracranial stenting with symptomatic intracranial artery stenosis is relatively high and it can be reduced by preoperative sufficient assessment and prudent selection, careful operation and strict management after operation.