切换至 "中华医学电子期刊资源库"
高级检索
中华介入放射学电子杂志

中华介入放射学电子杂志 ›› 2015, Vol. 03 ›› Issue (04) : 183 -185. doi: 10.3877/cma.j.issn.2095-5782.2015.04.002

所属专题： 文献；

神经介入

球囊扩张支架成形术治疗椎动脉狭窄致后循环脑缺血的效果分析
刘赫1, 贾建文1, 钟红亮1, 李荧1, 孙永全1,†()   
  1. 1. 100021　北京，首都医科大学附属北京朝阳医院神经介入科
  • 收稿日期:2015-07-12 出版日期:2015-11-01
  • 通信作者: 孙永全

Treatment of post circulation ischemia with vertebral artery stent angioplasty

He Liu1, Jianwen Jia1, Hongliang Zhong1, Ying Li1, Yongquan Sun1,†()   

  1. 1. Department of Interventional Neuroradiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
  • Received:2015-07-12 Published:2015-11-01
  • Corresponding author: Yongquan Sun
  • About author:
    Corresponding author: Sun Yongquan, Email:
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

刘赫, 贾建文, 钟红亮, 李荧, 孙永全. 球囊扩张支架成形术治疗椎动脉狭窄致后循环脑缺血的效果分析[J]. 中华介入放射学电子杂志, 2015, 03(04): 183-185.

He Liu, Jianwen Jia, Hongliang Zhong, Ying Li, Yongquan Sun. Treatment of post circulation ischemia with vertebral artery stent angioplasty[J]. Chinese Journal of Interventional Radiology(Electronic Edition), 2015, 03(04): 183-185.

目的

总结因椎动脉狭窄致后循环脑缺血的患者行支架成形手术的经验体会。

方法

47例因椎动脉狭窄致缺血性脑卒中的患者，于我科行椎动脉支架成形术,共留置支架52枚，其中椎动脉V1段为46枚，V4段6枚。所有患者行全脑血管造影或CT血管造影随访，平均随访6.3月。分析动脉狭窄改善及其他并发症情况。

结果

所有患者均成功行支架成形术。术后患者症状缓解率为85.1%（40/47）；术前狭窄率（75.2±6.7）%，术后狭窄率为(7.6±6.1)%。发生支架内再狭窄（IRS）9处（17%），8处为椎动脉起始部,1处为V4段。

结论

支架成形术是治疗缺血性椎动脉狭窄安全有效的方法，但应尽量避免IRS等术后并发症。

关键词: 支架成形术, 脑缺血, 椎动脉狭窄, 支架内再狭窄
Objective

To present treatment results with stent angioplasty of vertebral stenosis in post circulation ischemic patients.

Methods

Vertebral artery stent angioplasty were proformed in totally 47 patients confirmed vertebral artery stenosis with 52 stents. Among them, there were 46 stents implanted in vertebral ostim and 6 stents in V4 segment. All of the patients were followed by digital distraction angiography(DSA) and CT angiography. Average follow up duration was 6.3 months.

Results

ALL the stents were implanted successfully. Symptoms were improved in 85.1%(40/47) of the patients. The stenosis rate before stenting were (75.2±6.7)% compared with (7.6±6.1)% post stenting. In-stent recurrent stenosis (IRS) were conformed in 9(17%) stents, however 8 stents were implanted in vertebral ostium(V1 segment),1 stent were in V4 segment.

Conclusions

In experienced hands, stenting for symptomatic VAS can be accomplished with a very high success rate (100%),with few complications. We conclude that endovascular stenting of vertebral artery stenosis is safe and effective for ischemic disease.IRS should be avoided.

Key words: Stent, Vertebral artery ostium, Angioplasty, In-stent rcurrent senosis
1
Moulin T, Tatu L, Vuillier F, et al. Role of a stroke data bank in evaluating cerebral infarction subtypes: patterns and outcome of 1,776 consecutive patients from the Besancon stroke registry[J]. Cerebrovasc Dis, 2000, 10(4):261-271.
2
Gröschel K, Schnaudigel S, Pilgram SM, et al. A systematic review on outcome after stenting for intracranial atherosclerosis[J]. Stroke, 2009, 40(5):e340-e347.
3
North American Symptomatic Carotid Endarterectomy Trial Collaborators．Beneficial effects of carotid endarterectomy in symptomatic patients with high grade carotid stenosis[J]．N Engl J Med，1991，325:445-453．
4
Antoniou GA, Murray D, Georgiadis GS, et al. Percutaneous transluminal angioplasty and stenting in patients with proximal vertebral artery stenosis[J]. Journal of Vascular Surgery, 2012, 55(4):1167-77.
5
Jin M, Fu X, Wei Y, et al. Higher risk of recurrent ischemic events in patients with intracranial in-stent restenosis[J]. Stroke, 2013, 44:2990-2994.
6
Lal BK, Beach KW, Roubin GS, et al. Restenosis after carotid artery stenting and endarterectomy: a secondary analysis of CREST, a randomised controlled trial[J]. Lancet Neurol, 2012, 11(5):755-763.
7
Fifi JT, Brockington C, Narang J, et al. Clopidogrel resistance is associated with thromboembolic complications in patients undergoing neurovascular stenting[J]. AJNR Am J Neuroradiol,2013,34(4):716-720..
8
Stayman AN, Nogueira RG, Gupta R. A systematic review of stenting and angioplasty of symptomatic extracranial vertebral artery stenosis[J]. Stroke, 2011, 42(8):2212-2216.
[1] 邢小炜, 钱琦, 金平. 肝X受体β在电针治疗慢性脑缺血炎性损伤中的作用研究[J]. 中华危重症医学杂志(电子版), 2022, 15(02): 122-126.
[2] 张艳, 王俊, 严永兴, 顾婧, 魏颖楠, 沈咏慧. 3-乙酰基-11-酮-β乳香酸对大鼠脑缺血再灌注损伤的保护作用及其机制研究[J]. 中华危重症医学杂志(电子版), 2021, 14(06): 466-471.
[3] 何彬, 王静. 彩色多普勒超声血流参数、血清尿酸、胱抑素C对短暂性脑缺血发作患者颈动脉狭窄的诊断价值[J]. 中华神经创伤外科电子杂志, 2023, 09(05): 289-294.
[4] 关明函, 薛志强. 右美托咪定改善大鼠脑缺血再灌注后脑损伤的研究[J]. 中华神经创伤外科电子杂志, 2023, 09(05): 270-276.
[5] 王静, 何彬. 经颅彩色多普勒超声联合血sCD40L、Fib、PAF对短暂性脑缺血发作后脑梗死的预测效果[J]. 中华神经创伤外科电子杂志, 2023, 09(04): 222-227.
[6] 周帅, 王海波, 刘朋飞, 张继红, 马晓艳, 王喆, 张文学, 王金鹏, 王明鑫, 姜丽娜. 症状性椎动脉起始部重度狭窄/闭塞行椎动脉内膜切除术的疗效分析[J]. 中华神经创伤外科电子杂志, 2023, 09(03): 170-174.
[7] 杨梦琦, 马慧芬, 訾阳, 王楠, 杜冰玉, 常万鹏, 于少泓. 马黛茶对脑血管疾病防治作用的研究进展[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(04): 235-240.
[8] 郑薏, 彭雯雯, 钟月丽. MicroRNA-34a调控电针对缺血再灌注损伤大鼠反应性星形胶质细胞的影响[J]. 中华脑科疾病与康复杂志(电子版), 2023, 13(03): 135-141.
[9] 季鹏, 郭言言, 王超. CT灌注成像联合CT血管造影对TIA患者进展为急性脑梗死的预测[J]. 中华介入放射学电子杂志, 2023, 11(02): 128-132.
[10] 刘萍, 郝庭嘉, 解远峰, 赵堂海, 秦少华. 利伐沙班在下肢深静脉血栓形成后综合征腔内治疗术后的疗效研究[J]. 中华介入放射学电子杂志, 2023, 11(02): 101-105.
[11] 江哲宇, 蒋天鹏, 周石, 王黎洲. 微小RNA在脑缺血再灌注损伤中的研究现状与进展[J]. 中华介入放射学电子杂志, 2022, 10(01): 75-82.
[12] 陈猛, 孟润祺, 曹勇, 张金国. 冠状动脉支架内再狭窄的影像诊断与治疗研究进展[J]. 中华诊断学电子杂志, 2023, 11(01): 12-16.
[13] 佟志勇, 刘源, 潘起晨, 邹存义, 程德殊, 赵旭东, 张劲松, 金友贺, 娄喆. 颈动脉内膜切除补片成形术治疗支架内再狭窄的长期疗效分析[J]. 中华脑血管病杂志(电子版), 2022, 16(06): 398-407.
[14] 朱旭, 郭翠霞, 魏洁, 张宁, 王喜旺, 于国渊. 脑灌注压联合血小板体积指数对颅内动脉瘤栓塞术后迟发性脑缺血的预测价值[J]. 中华脑血管病杂志(电子版), 2022, 16(06): 392-397.
[15] 洪泽璇, 陶涛, 秦再生. 蛋白质翻译后修饰在脑缺血再灌注中的作用[J]. 中华脑血管病杂志(电子版), 2022, 16(02): 125-129.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号