3例慢性颅内动脉闭塞和次全闭塞的血管内介入再通治疗

Endovascular interventional recanalization for chronic intracranial arterial(near) occlusion: 3 cases report

目的以3例慢性颅内动脉闭塞和次全闭塞获得再通的病例资料为基础,探讨经皮腔内血管成形和支架植入术(PTAS)的疗效及安全性。方法回顾分析本院神经内科收治的3例慢性颅内动脉闭塞和次全闭塞接受PTAS获得再通病例的临床资料,以改良Rankin评分(mRS)、Barthel指数评估疗效和安全性。结果 3例均为男性,平均年龄50.7岁;1例为颈内动脉颅内段闭塞,2例为大脑中动脉M1段闭塞;2例行单纯球囊扩张术,1例行球囊扩张术和支架植入术。所有患者都实现了闭塞部位的完全再通,未发生围术期并发症。术后随访无短暂性脑缺血和脑卒中复发,m RS评分均为0分。结论慢性颅内动脉闭塞和次全闭塞的治疗选择需综合考虑多种因素,血管内介入再通是较为安全有效的方法,但远期疗效和安全性尚需进一步临床研究评定。

Objective To evaluate the efficacy and safety of endovascular treatment in chronic intracranial arterial(near) occlusion patients, who were treated with percutenous transluminal angioplasty and stenting(PTAS). Methods Three male patients with chronic intracranial arterial(near) occlusion, who were treated with PTAS in the neurology department of Shanghai Ninth's People Hospital affiliated to Shanghai Jiaotong University School of Medicine, were enrolled. Their clinical data were retrospectively analyzed through the modified Rankin Scale(m RS) and Barthel index. Results Three patients, whose mean age was 50.7 years old, include one case of intracranial internal carotid artery occlusion, who received balloon dilation plus stenting, and two cases of middle cerebralartery M1 segment occlusion, who received balloon dilation. All patients achieved complete recanalization of occlusion lesions, with no perioperative complications. There was no transient ischemic attack or stroke occurred during follow-up, and the m RS were 0. Conclusion The choice of treatment for chronic intracranial arterial(near) occlusion depends on various factors. Endovascular interventional recanalization for intracranial arterial(near) occlusion is technically feasible. Further studies are needed to evaluate its long-term outcome and safety.