锁骨下动脉窃血综合征的腔内治疗

目的:探讨锁骨下动脉窃血综合征的腔内治疗效果。方法:回顾性分析10年间86例行血管腔内治疗的锁骨下动脉窃血综合征患者临床资料,其中锁骨下动脉闭塞11例,狭窄75例,狭窄程度均>70%。结果:86例患者均成功释放支架,无并发症发生。支架置入术后即刻造影显示:锁骨下动脉狭窄或闭塞段血流通畅,椎动脉血流正向。术后患侧肱动脉即刻恢复搏动,与健侧压差<10 mmHg(1 mmHg=0.133 kPa)。72例患者获随访,平均随访24个月。2例死于恶性肿瘤,4例死于心肌梗死。其余随访患者椎-基底动脉缺血及上肢缺血症状均明显改善或消失。复查超声提示:支架无脱落及移位,血流通畅。结论:锁骨下动脉窃血综合征的腔内治疗微创、安全、成功率高,近期效果肯定,可作为首选治疗方法。

Endovascular treatment of subclavian steal syndrome

Objective:To investigate the clinical efficacy of endovascular treatment of subclavian steal syndrome(SSS). Methods:The clinical data of 86 patients with SSS undergoing endovascular treatment over the past 10 years were retrospectively analyzed.Of the patients,there were 11 cases of subclavian occlusion and 75 cases of subclavian stenosis(the stenosis degree of all the 75 cases greater than 70%). Results:Stents were deployed successfully in all patients and no intraprocedural complications occurred.Immediate postoperative angiography revealed that the stenotic or occlusive segments of the subclavian artery were patent and antegrade vertebral blood flow was restored.Arterial pulsations of the treated arm rapidly returned to normal and the differences in blood pressure between arms were less than 10 mmHg(1 mmHg=0.133 kPa).Follow-up was obtained in 72 patients with average period of 24 months.Of the follow-up patients,2 cases died of malignant tumor,4 cases died of myocardial infarction,and the symptoms of vertebral basilar insufficiency and upper extremity ischemia were improved or eliminated in the rest of the cases.The follow-up Doppler ultrasound examination showed that all the stents were patent and intact,with no evidence of stent migration. Conclusion:Endovascular treatment of SSS is safe and minimally invasive,with high success rate and good short-term efficacy.It should be the first choice of treatment for this condition.