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支架辅助血管成形术在症状性颅内动脉狭窄治疗中的应用
作者姓名:Miao Z  Ling F  Li S  Wang M  Hua Y  Guo D  Dong Y  Song Q
作者单位:1. 100053,北京,首都医科大学宣武医院介入中心
2. 100053,北京,首都医科大学宣武医院神经外科
3. 100053,北京,首都医科大学宣武医院神经内科
4. 100053,北京,首都医科大学宣武医院超声科
5. 100053,北京,首都医科大学宣武医院放射科
摘    要:目的 探讨症状性颅内动脉狭窄支架治疗的适应证和操作技术及疗效。方法 7例颅内血管狭窄患者,有反复发作与血管狭窄有关的神经功能障碍,内科抗凝和抗血小板治疗无效。其中大脑中动脉3例,颈内动脉末段1例,基底动脉1例,椎动脉颅内段2例。使用冠状动脉支架,采用经皮支架辅助血管成型术使狭窄血管扩张。结果 7例患者在血管造影上狭窄程度明显改善,从术前平均狭窄83%下降到5%。其中1例随访3个月,临床症状明显。支架置入部位未见再狭窄。1例在手术过程中有颅内出血,6例在0-3个月内没有出现神经功能障碍或中风发作。结论 经皮支架辅助血管成型术可以有效治疗动脉粥样硬化性颅内动脉狭窄,但这一结果还有待长期随访以及其技术和应用材料有待于进一步的研究和探讨。

关 键 词:症状性颅内动脉狭窄  支架辅助血管成形术  治疗
修稿时间:2002年1月30日

Stent-assisted angioplasty in treatment of symptomatic intracranial artery stenosis
Miao Z,Ling F,Li S,Wang M,Hua Y,Guo D,Dong Y,Song Q.Stent-assisted angioplasty in treatment of symptomatic intracranial artery stenosis[J].National Medical Journal of China,2002,82(10):657-660.
Authors:Miao Zhongrong  Ling Feng  Li Shenmao  Wang Moli  Hua Yang  Guo Dongmei  Dong Yan  Song Qingbin
Institution:Center of Intervention, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
Abstract:Objective To investigate the indications, safety and effectiveness of intracranial deployment of stents in treatment of systematic intracranial artery stenosis. Methods Stent assisted angioplasty was performed upon 7 consecutive patients with symptoms of intracranial artery stenosis unresponsive to anticoagulant theray and antiplatelet therapy. The lesions involved the middle cerebral artery in 3 cases, distal end of internal carotid artery in one case, basilar artery in one case, and intracranial section of vertebral artery in 2 cases. Short term clinical and angiographic data were obtained. Results Symptoms of procedure related intracranial hemorrage and intracranial haemotoma developed later were found in one patient. Emergency craniotomy was performed 5 hours after the stenosis assisted angioplasty. The remaining patients experienced alleviation of symptoms without transient ischemic attack and apoplexy during the short term follow up. Angiography showed that the stenosis degree reduced from 83% to 5%. 0 3 months of follow up by transcranial Doppler showed good patency of stented lesions. Conclusion Stent assisted angioplasty effectively treats atherosclerotic intracranial stenosis lesions. Long term follow up and further clinical/technical research are still needed.
Keywords:Cerebral artery diseases  Angioplsty  Stents
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