术前脑血管造影在血管内支架成形术治疗缺血性脑血管病中的应用

目的：探讨术前脑血管造影在血管内支架成形术治疗脑供血动脉狭窄中的应用价值。方法：对105例症状性脑缺血发作患者进行术前全脑血管造影。对136支狭窄的血管进行了血管内支架成形术。术后不同时期进行脑血管造影随访。结果：105例患者术前共存在136处狭窄血管，支架治疗术后70处血管狭窄恢复了正常血管直径，54处残余狭窄小于20%，7处残余狭窄界于50%～80%之间，有5例因支架不能到位，放弃手术。术中血栓保护伞完全被封堵住1例。所有患者术前症状均有不同程度的缓解，70例患者获得术后1～24个月的脑血管造影随访，其中颈动脉再狭窄2例，椎动脉起始部再狭窄6例，颅内动脉再狭窄6例。结论：术前进行充分的脑血管造影评估，以制定个体化的治疗方案，可以提高血管内支架成形术的安全性。

Role of pre-operative cerebral angiography in cerebral artery stenosis stent angioplasty

Objective: To study the value of pre-operative cerebral angiography in cerebral artery stenosis stent angioplasty.Methods: One hundred and five patients with symptomatic cerebral ischemic attack received cerebral angiography.One hundred and thirty-six narrow blood vessels were stent implanted.Results: After operation,seventy narrow blood vessels reverted to type,fifty-four maintained stenosis of less than 20%,and seven maintained stenosis of 50% to 80%.Five narrow blood vessels failed.In the operations,the thrombus protective umbrella was stemmed completely in one case.Symptoms were improved in all patients.Seventy cases were followed up by angiography between one month and twenty-four months,stenosis recurred in two cases in the carotid artery,six cases in the beginning of the vertebral artery and six cases in the intracranial artery.Conclusions: Angiography and individual therapy are helpful for cerebral artery stent angioplasty.