血管内支架成形术治疗脑动脉闭塞的临床研究(附38例报告)

目的观察动脉内超选择性溶栓或/和血管内支架成形术治疗急性或进展性缺血性脑梗死的疗效及并发症。方法采用随机对照方法,将38例因粥样硬化所致急性或进展性脑血管栓塞病例,分为治疗组21例(选择性脑动脉内接触溶栓辅以血管内支架成形术)和对照组17例(单纯选择性脑动脉内接触溶栓),进行疗效及并发症等方面的对比研究。结果治疗组治疗急性或进展性缺血性脑梗死,其血管再通率、神经功能缺损评分降低程度、临床预后均优于对照组;治疗后血管再狭窄、再闭塞率低于对照组;症状性出血率高于对照组。结论选择性脑动脉内接触溶栓结合血管内支架成形术治疗急性或进展性缺血性脑梗死,是一积极、有效、相对安全的方法。

In-stent assisted angioplasty for cerebral artery occlusion, report of 38 cases

Objective To investigate the therapeutic effect and complications of superselective endoarterial thrombolysis and/or endovascular stent assisted angioplasty for the treatment of acute or progressive ischemic cerebral infarction.Methods Thirty-eight patients were diagnosed as with acute or progressive ischemic cerebral infarction.resulted from arteriosclerosis.All cases were randomly divided into treatment group(21 cases),which underwent selective intra-arterial contact thrombolysis and endovascular stent angioplasty;and contrast group(17 cases),which were treated only with intra-arterial contact thrombolysis.A comparison of therapeutic effect and complications between this two groups was carried out.Results The revascularization rate,decrease extent of the scores for neurological defect,and clinical results were all prior in treatment group to those in contrast group.After therapy,the arterial restenosis rate and reocclusion rate of the patients from treatment group were lower than that of the patients from contrast group.While the occurrence of symptomatic hemorrhage was higher in the treatment group than that in the contrast group.Conclusion Combined with endovascular stent angioplasty,selective endoarterial thrombolysis for the treatment of acute or progressive is chemic cerebral infarction is an acitive,effective and relatively safe therapeutic method.