12例椎-基底动脉串联病变的血管内治疗探讨

目的探讨经皮血管内支架成形术(PTAS)治疗椎-基底动脉重度狭窄串联病变的有效性、安全性及可行性。方法对12例(26处)经药物治疗无效的症状性椎-基底动脉串联病变患者采用经皮血管内支架成形术治疗。术前DSA示动脉直径狭窄率为65～100%,平均84.62±8.24%。结果本组支架置放成功率92.6%,术后平均狭窄率为16.92±14.84%;术后用mRS量表(改良RANKIN量表)评分,7例0分,3例1分,2例3分。发生2例围手术期并发症,年卒中率为6.2%;随访期间2例发生支架内再狭窄。结论血管内支架成形术治疗椎-基底动脉串联病变,在技术上可行,远期疗效良好。

Percutaneous transluminal angioplasty and stenting for tandem vertebrobasilar artery stenosis

Objective To study the efficiency,security and feasibility of percutaneous transluminal angioplasty and stenting(PTAS) for symptomatic tandem vertebrobasilar artery stenosis.Methods 12 patients with 26 tandem vertebrobasilar artery stenoses undergoing elective PTAS were retrospectively analyzed.The preoperative symptoms were refractory to medical therapy.DSA showed that the stenosis rate ranged from 65% to 100%,averaging 84.62 ± 8.24%.Results Success rate of PTAS was 92.6%,Postoperative the average stenosis rate after PTAS was16.92 ± 14.84%;Evaluated with mRS,7 cases mRS = 0;3 cases mRS = 1;2 cases mRS = 3;There were 2 major periprocedural complications without fatality.Stroke rates in vertebrobasilar artery territory(per 100 patientyears of follow-up) were 6.2 in patients with vertebrobasilar artery stenosis;During the follow-up period,2 patients(16.7%) had in-stent restenosis confirmed by cerebral angiography or transcranial Doppler(TCD).Conclusion Stent-assisted angioplasty is a feasible technical method for the treatment of tandem vertebrobasilar artery stenosis,andthe long-term effect is good.