穿支卒中与颅内动脉狭窄支架成形术

穿支卒中(PS)足颅内动脉狭窄支架成形术的一种并发症。颅内动脉存在较多的穿支动脉,其闭塞可能导致致命性后果。根据冠脉血管的临床研究,目前对PS的机制有3种推论:雪梨效应、支架封堵作用和血管内膜增生,并且在动物实验中也观察到了这3类现象。各治疗中心在治疗颅内动脉狭窄的同时已经对PS有所探讨。术前MRI提示患者存在临近狭窄部位穿支梗死(PIAS)使得发生PS的风险增加。易发生PS患者的特点还包括了狭窄的形态、部位、成因以及手术术式和手术器材选择。对于PS的预防仍然任重道远,而随着研究的深入,PS的机制也将逐步阐明。

Perforator stroke and stenting of intracranial afterial stenosis

Perforator stroke(PS)is one of peri-procedural complications associated with stenting of intracranial arterial stenosis.A lot of perforator arteries are derived from intracranial arteries with difference from coronary arteries,because once the intracranial perforator arteries of crucial regions are occluded,may lead to fatal prognosis.Three hypothesis have been used to explain PS including snow-plowing,stent jailing effect and in-stent neointimal growth.In vivo models,investigators have already found these phenomenas.After much attention been paid on PS,authors have published a report covered with a large amount of cases in 2006. The author figured out that patients with perforator infarct adjacent to the stenotie segment(PIAS)under MRI beforehand would have higher chance occurring PS after stenting of intracranial stenosis.The patients with priority of PS easily are affected by the morphology,location,etiology,sites,the type and equipments.Many yet unsolved problems including the prevention would arouse us to go deeper into for the exploration of the mechanism.(J Intervent Radiol,2007,16:858-862)