Neuroform支架在治疗症状性颅内动脉狭窄中的应用

目的评价使用Neuroform支架在治疗症状性颅内动脉狭窄的安全性、可行性。方法症状性颅内动脉狭窄患者11例,其中前循环狭窄2例(1例狭窄位于颈内动脉眼段交通段,1例狭窄位于大脑中动脉M1段),后循环狭窄9例(3例狭窄位于基底动脉,6例狭窄位于基底动脉交界处);均进行支架成形术治疗,术后全脑血管造影复查及使用美国国立卫生研究院脑卒中量表(NIHSS)进行评定。结果11例患者支架全部置放成功,造影复查显示动脉直径狭窄率从术前(85.6±7.4)%降至术后(35.7±12.1)%。按NIHSS评分评估,11例患者术后症状明显改善,其中1例患者术后15天出现Wallenberg综合征,随访1~12个月,其他患者未出现脑缺血再发作及支架内再狭窄。结论应用Neuroform支架治疗症状性颅内动脉狭窄合并路径血管纡曲不光滑的患者,可以提高手术成功率,减轻临床缺血症状和改善预后。

Application of Neuroform stent in treatment of symptomatic intracranial arterial stenosis

Objective To assess the safety and feasibility of Neuroform stent in treatment of symptomatic intracranial arterial stenosis.Methods Eleven patients with symptomatic intracranial arterial stenosis were treated with stent-assisted angioplasty.The lesions of 2 patients were located in anterior circulation(supraclinoid segment of internal carotid artery and middle cerebral artery)and those of 9 patients were located in posterior circulation(3 at basilar artery and 6 at the juncture of vetebral and basilar arteries).The patients were re-examined by DSA and assessed by means of the NIH stroke scale(NIHSS)postoperatively.Results All the 11 cases were treated with stent-assisted angioplasty.Pretreatment stenosis was(85.6±7.4)%,and was improved to become(35.7±12.1)% after stent placement.There was significant clinical improvement of NIHSS score in 11 cases after stent placement.One case was complicated by Wallenberg syndrome.During the follow-up for 1-12 months,there was no recurrence of transient ischemic attack,stroke or restenosis in 10 patients.Conclusion Stent-assisted angioplasty with Neuroform stent can be performed with a high rate of technical success in the patients with symptomatic intracranial arterial stenosis complicated by tortuosity and unsmoothness of the vessel,alleviate symptom of ischemia and improve prognosis.