颅内动脉狭窄支架成形术后影响分支缺血性事件的临床因素探讨

目的 探讨颅内动脉狭窄支架成形术（ICASS）后支架置入与临床对应分支缺血性事件的相关性及其影响因素.方法 21例24支颅内大动脉狭窄,行血管内支架成形术.其中大脑中动脉（MCA）15支,椎动脉（VA）5支,基底动脉（BA）3支和颈内动脉（ICA）1支.20支血管（MCA 14支,VA 3支,BA 2支和ICA 1支）为症状性重度狭窄、1支（BA）为无症状性重度狭窄;3支血管（MCA 1支和VA 2支）为症状性中度狭窄.比较评价支架成形术对分支缺血性损害、总体预后等方面的影响.结果 无支架置入性相关分支缺血性损害的表现,随访期（6～27个月）内无再狭窄;所有患者均无手术相关性并发症.结论 在围手术期规范化临床干预下,颅内动脉狭窄支架成形术不会导致明显的理论性支架相关性分支缺血性并发症,但这还需要进一步的验证.

Clinical factors relate to side branches ischemic events after stenting for intracranial artery stenosis

Objective To discuss the affective factors and relations of clinical ischemic events to the side branches following stenting for intracranial artery stenosis （ICAS）. Methods 21 patients with 24 branches stenosis of intracranial large artery were treated by stenting. Among them, 15 MCA,5 VA,3 BA andl ICA. 20 vessels（14 MCA,3 VA,2 BA and 1 ICA） are symptom and 1 vessel （BA） is asymptomatic with severe stenosis,3 vessels （1 MCA and 2 VA） are symptomatic medium stenosis. To compare and evaluate clinic affective factors of stent to stent-related ischemic damages and overall prognosis. Result There was no related ischemic complications of the side branches following stenting. There was no restenosis in follow-up period （6 -27 months） and complications related to stenting for the all. Conclusion There were no obvious isehemic complications related to theoretic branches covered following stenting with standard therapy for the patients with ICASS, but it needs further studies.