椎动脉开口部狭窄的支架成形术及长期随访

目的评价椎动脉开口狭窄的支架成形手术的安全性、可行性和远期疗效。方法41例（48处病变）椎动脉开口狭窄（狭窄率≥50％）患者接受了支架成形术治疗。结果男37例,女4例。技术成功率为97．9％,1例术后发生右侧枕叶栓塞事件。术后30d内无1例死亡。21例（26处靶病变）进行了造影复查,9例（9处靶病变）发生支架内再狭窄（34．6％）,2例为症状性再狭窄。结论此种治疗方法安全可行,能够预防病变相关供血区的卒中和死亡,有效减少后循环短暂脑缺血发作事件。

Stent-assisted angioplasty and long-term results in atherosclerotic vertebral artery ostial stenosis

OBJECTIVE: To evaluate the safety, feasibility and long-term results of stent-assisted angioplasty in atherosclerotic ostial stenosis of vertebral artery (VA). METHODS: Forty one patients (48 lesions) with symptomatic cerebral ischemic events or stroke attributed to VA atherosclerotic ostial stenosis > or = 50% (NASCET method) found in digital subtraction angiography (DSA) were approached for consent to participate in the study. During the procedure, three cases used protection devices and three used drug-eluting stents. RESULTS: Thirty seven of the patients were male and 4 female. Mean age was 63.4 years (range 36 - 80). Technical success was achieved in 97.9 % of the lesions. One suffered from a stroke that occurred within 30-days postprocedural. 37 patients were followed up for 22.4 months. The clinical follow-up outcomes showed that there were no lesion-related strokes and deaths, three appeared to have return of neurological symptoms (TIA). Among the 21 patients (26 lesions) who had angiography follow-up, re-stenosis (> or = 50%) was revealed in 9 patients (9 lesions) (34.6%). However, seven of these 9 patients remained asymptomatic. CONCLUSIONS: Stent-assisted angioplasty for atherosclerotic ostial stenosis of VA is safe and feasible. It can prevent the lesion-related stroke, death and TIA recurrence. However, further studies are needed to clarify how to reduce the relatively high re-stenosis rate.