血管内支架成形术治疗脑动脉狭窄——附16例报告

目的介绍脑动脉狭窄血管内支架植入术的基本方法。总结16例治疗经验体会及并发症的发生与防治。方法16例脑动脉狭窄患者行腔内支架成形术，共置人支架20个，其中锁骨下动脉1个，颈总动脉2个，颈内动脉起始部11个，椎动脉6个，应用脑保护装置12只。结果16例支架全部置人成功，15例狭窄减少〉80％。1例减少〉70％。12例脑保护装置均成功释放及回收，2例患者术中因低血压、低灌注出现偏瘫。经救治恢复。2例年龄80岁以上患者术后出现肺部感染、心功能不全等并发症。结论脑动脉狭窄经皮血管内支架成形术是治疗脑动脉狭窄新的有效治疗方法，在严格掌握适应症和有经验的医生操作下，治疗是安全的。高龄患者并发症增多应引起重视。使用脑保护装置可明显减少神经系统并发症。

Stent-assistant angioplasty in treatment of cerebral artery stenosis: a report of 16 case

Objective levaluate the stent-assistant angioplasty in treatment of cerebral artery stenosis. Methods The procedures of stent-assistant angioplasty were performed in 16 patients with severe cerebral artery stenosis. Total 20 stents were implanted, of which 13 were in carotid artery, 6 in vertebrobasilar artery, 1 in subclavian artery. Twelve of these patients were operated under cerebral protection. Results Stents were successfully implanted in all patients, the degree of stenosis reduced more than 80% in 15 patients and 70% in 1 patient. Twelve filter devices for cerebral protection were used successfully. During pcripre, cedure, 2 patients had consciousness lose and/or acroparalysis because of lower blood pressure, and recovered after operation. Two patients whose age was more then 80 suffered from pulmonary infection and acute cardiac insufficiency. Conclusion Endovascular stenting is safe and effective technique in treatment of cerebral artery stenosis, particularly under cerebral protection.