支架置入术治疗头臂型多发性大动脉炎

目的探讨头臂型大动脉炎支架置入的治疗方法及疗效。方法回顾性分析19例经支架置入术治疗的重型头臂型多发性大动脉炎患者的临床资料。本组患者均为女性，年龄为18～37岁，平均27．8岁。发病时间0．7～5．0年，平均3．4年。结果对19例患者的24支目标血管进行介入治疗，22支目标血管开通成功后，进行了支架置入术治疗，技术成功率为91．7％（22／24）；其中双侧颈总动脉支架置人术2例，单侧颈总动脉或颈内动脉支架置入术6例，单侧颈总动脉合并单侧锁骨下动脉一椎动脉支架置人术1例，单侧锁骨下动脉一椎动脉支架置入术10例。术后18例（2支完全闭塞的颈动脉未开通成功，但随后成功开通了闭塞的锁骨下动脉一椎动脉）缺血症状均明显缓解，头晕、头痛等症状明显缓解，视力明显恢复。有效率为94．7％（18／19）。17例患者得到随访，随访时间为8～36个月，平均19．4个月，其中1例患者术后22个月突发枕叶梗死。8例患者偶有头痛、头晕发生。结论血管内介入手术是治疗重型头臂型多发I生大动脉炎的一种安全和有效的方法。

Stenting for Takayasu arteritis of brachiocephalic type

Objective To investigate the efficacy of stent treatment for brachioeephalic type Takayasu arteritis. Methods The clinical data of 19 patients with severe Takayasu arteritis of brachiocephalic type treated with stenting were analyzed retrospectively. All the patients in this group were women, ranged in age from 18 to 37 years （mean, 27.8 years）. The duration of disease was 0. 7 to 5 years （mean, 3.4 years）. Results Twenty-four target vessels in 19 patients were treated with interventional methods. After 22 target vessels were recanalized successfully, they were treated with stenting. The technical success rate was 91.7% （22/24）. Of these, 2 patients had bilateral common carotid artery （CCA） stenting, 6 had unilateral CCA or internal carotid artery （ICA） stenting, one had unilateral CCA and bilateral subclavian artery （SA）-vertebral artery （VA） stenting, and 10 had unilateral SA-VA stenting. Cerebral ischemia symptoms of 18 patients （2 completely occluded carotid arteries failed to be recanalized, but the occluded SA-VAs were recanalized suc- cessfully） after the procedures were alleviated significantly, the symptoms of dizziness and headache were also alleviated obviously, and the visual acuity was improved significantly. The effective rate was 94.7% （ 18/ 19）. Seventeen patients were followed-up for 8 to 36 months （ mean, 19.4 months）, and one of them had occip- ital lobe infarction suddenly 22 months after the surgery, and 8 had occasional dizziness. Conclusion Endo- vascular intervention is a safe and effective way to treat severe brachiocephalic type Takayasu arteritis.