支架术治疗症状性MCA狭窄的围手术期并发症及其管理

目的观察支架术治疗症状性MCA狭窄的围手术期并发症，探讨规范的围手术期管理在并发症防治中的意义。方法对26例症状性MCA狭窄患者行支架术，手术患者均实施规范的围手术期管理，观察围手术期并发症及其发生率。结果手术成功率92．4％（24／26），术后造影显示MCA狭窄程度由术前的78％下降至不到10％。围手术期有5例患者出现并发症，血管痉挛1例，血管破裂致蛛网膜下腔出血1例，大脑中动脉急性闭塞1例，高灌注综合征1例，支架内血栓形成死亡1例。其中血管急性闭塞、支架内血栓形成与围手术期管理不善有关。结论支架术治疗大脑中动脉狭窄手术成功率高，疗效确切；规范化围手术期管理对于防治支架术治疗大脑中动脉狭窄的并发症具有重要意义，可以避免绝大多数并发症的发生，使手术更安全。

Periprocedural complications of symptomatic MCA stenosis treated with stenting-angioplasty around operation and its management

Objective To observe periprocedural complications of symptomatic MCA stenosis treated with stenting-angioplasty,discuss its prevention,and explore the importance of periprocedural management.Methods 26 patients of symptomatic MCA stenosis(more than 78%)were performed stenting-angioplasty.All cases were executed periprocedural management and occurrence rate of complications was observed.Results 24 cases' opera- tion succeeded in technique and 2 cases failed.MCA stenosis degree was reduced to less than 10%.6 cases occured periprocedural complications,including vessel spasm(1 cases),vascular rupture(1 case),acute occlusion(1 case), hyper-perfusion syndrome(1 cases)and thromrosis in stent to death(1 case).Some complication was relevant to bad periprocedural management.Conclusion It is a feasible and effective technique to treat symptomatic MCA stenosis with stenting-angioplasty.It is important that periprocedural standardization management is carried out periprocedure,and good management can avoid majority of complications,make stenting-angioplasty safer.