双侧椎动脉重度狭窄/闭塞导致头晕患者的侧支循环代偿途径特点分析

Analysis of characteristics of collateral circulation pathways in dizziness patients caused by severe bilateral vertebral artery stenosis/occlusion

回顾性分析2018年10月至2020年10月解放军总医院第六医学中心神经内科收治的47例经数字血管减影术(DSA)证实存在双侧椎动脉重度狭窄/闭塞患者的临床资料及侧支循环代偿特点。其中男41例,女6例,年龄(62±7)岁。颅内外共存在8种代偿途径,颅内以后交通动脉为主(21例)、颅外以颈深动脉侧支为主(16例)。不同部位病变启动的代偿途径不同,对于此类患者进行DSA评估,有助于患者预后判断及个体化治疗方案选择。

The clinical data of 47 patients[41 males,6 females,aged(62±7)years]treated at the Department of Neurology of the Sixth Medical Center of PLA General Hospital from October 2018 to October 2020 who were diagnosed with severe bilateral vertebral artery stenosis/occlusion through Digital Subtraction Angiography(DSA)were retrospectively collected,and the characteristics of the compensatory pathways of collateral circulation were determined.Results showed that there were 8 intracranial and extracranial compensatory pathways,with posterior communicating artery as the major type(21 cases)for intracranial ones and deep carotid artery as the major type(16 cases)for extracranial ones.As the establishment of the compensatory pathway is closely related to the lesion site,DSA assessment for patients with severe bilateral vertebral artery stenosis/occlusion is helpful for clinicians to make judgement on prognosis of patients and choose individualized treatment plans.