血管内支架成形术治疗有症状大脑中动脉狭窄

目的探讨血管内支架成形术在有症状大脑中动脉狭窄治疗中的应用。方法对3例临床诊断脑梗死和3例短暂性脑缺血发作患者行全脑血管造影术,发现大脑中动脉M1段存在不同程度狭窄,对狭窄段大脑中动脉行颅内支架成形术。结果6例大脑中动脉支架成形术均获得成功。大脑中动脉M1段平均直径狭窄程度从92·8%降至6%(P<0·01)。1例患者在支架置入10min后出现急性血栓形成,术中经微导管注入尿激酶接触性溶栓,25min后血栓溶解。术后随访6个月,所有患者均无脑缺血事件发生。结论采用血管内支架成形术治疗有症状大脑中动脉狭窄可行。

Angioplasty and Stenting for Symptomatic Middle Cerebral Artery Stenosis

Objectives: To investigate the application of angioplasty and stenting in the treatment of symptomatic middle cerebral artery (MCA) stenosis. Methods: Cerebral angiography was performed on 3 patients with cerebral infarction and 3 patients with transient ischemic attack. The stenosis of various degrees in middle cerebral artery M1 segment was detected. Angioplasty and stenting were performed in the stenosis segment of middle cerebral artery. Results: Angioplasty and stenting were successful in all 6 patients. The stenosis degree of mean diameter in middle cerebral artery M1 segment was reduced from 92.8% to 6% (P<0.01). One patient developed acute cerebral thrombosis 10 minutes after angioplasty and stenting. Urokinase was infused via microcatheter for contact thrombolysis during the operation, and 25 minutes later the thrombus was dissolved. No cerebral ischemic event occurred in all patients during the 6-month follow-up. Conclusions: The use of angioplasty and stenting for aymptomatic middle cerebral artery stenosis is feasible.