Gateway—Wingspan球囊支架系统治疗基底动脉慢性狭窄的疗效观察

目的评价Gateway—Wingspan球囊支架系统治疗基底动脉狭窄的安全性及有效性。方法回顾性分析20例应用Gateway—Wingspan球囊支架系统治疗基底动脉慢性狭窄患者的临床资料，观察支架置人的手术成功率、狭窄率的改变、围手术期并发症及术后症状改善的情况。结果①20例基底动脉狭窄病变，共置入20枚Wingspan支架，技术成功率为100％。②术后即刻造影证实，狭窄率由（79．0±6．0）％下降至（13．0±3．4）％。围手术期1例发生小脑前下动脉闭塞，导致脑干梗死。③本组在术后1、3、6个月进行随访，根据Malek评分，术后3次评分均为1分者共12例（60％），均为2分者2例（10％），均为3分者1例（5％）。这15例患者的病情稳定，其中12例疗效肯定；其余5例术后早期疗效明显，但以后有所下降，其中有3例（15％）1个月时评分为1，3个月时转为2分；有2例（10％）1、3个月为1分，6个月时转为2分。结论经短期随访发现，采用Gateway—Wingspan球囊支架系统治疗基底动脉狭窄安全性及疗效均良好。

Gateway-Wingspan stent system assisted angioplasty for treatment of chronic basilar artery stenosis

Objective To assess the feasibility and safety of Gateway -Wingspan stent system assisted angioplasty for treatment of basilar artery stenosis. Methods The operative strategy, efficiency, successful rate, the degree of stenosis and periprocedural neurological complications were analyzed retrospec- tively in 20 patients after Gateway -Wingspan stent system assisted angioplasty for treatment of chronic basilar arterial stenosis. Results 20 patients of basiiar artery stenosis using stent assisted angioplasty were implanted 20 Wingspan stents. The stent implantation was successful in all patients. The mean degree of stenosis decreased from （79.0 ± 6.0 ） % before the procedure to （ 13.0 ±3.4） % after stenting. One patient advent brain stem infarction because of AICA occlusion. During the follow-up of 1,3 and 6 month , according to Malek scale, twelve patients （60%） belonged to scale 1, two patients （10%） belonged to scale 3, and one patient（5% ） belonged to scale 1. All of 15 patients were in stable condition. Among them, the treatment efficiency of twelve patients were very successful. In addition, 5 patients treatment effect was very good in the early postoperative period, but the treatment effect was gradually decreased. Among them, 3 patients （ 15% ） belonged to scale 1 after one month, but belonged to scale 2 after three months. In addition, 2 patients（ 10% ） belonged to scale 2 in 1,3 month, but belonged to scale 2 after six months. Conclusion Gateway-Wingspan stem system assisted angioplasty is safe and feasible for treatment of basilar artery stenosis.