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75岁以上脑血管病患者脑血管造影临床分析
引用本文:韩轶鹏,王大明,刘加春,王利军,陆军,祁鹏.75岁以上脑血管病患者脑血管造影临床分析[J].中华老年医学杂志,2010,29(5).
作者姓名:韩轶鹏  王大明  刘加春  王利军  陆军  祁鹏
作者单位:1. 北京协和医学院研究生院卫生部北京老年医学研究所,100730
2. 卫生部北京医院神经外科
摘    要:目的 分析75岁以上患者脑血管造影实施、病变分布、并发症等情况.方法 83例75岁以上患者行全脑及双锁骨下动脉造影术,缺血性脑血管病61例(73.5%),出血性脑血管病22例(26.5%).结果 83例造影中78例(94.0%)造影经股动脉完成,11例(13.3%)造影中应用复合弯曲导管.缺血性脑血管病例中前循环狭窄107处(占67.3%),后循环52处(占32.7%);颅外97处(占61.0%),颅内62处(占39.0%);发现8例(占13.1%)患者存在9个未破裂动脉瘤.出血性脑血管病中16例(72.6%)存在颅内动脉瘤,共发现动脉瘤19个.5例(6.0%)出现并发症,一过性神经系统并发症2例(2.4%),穿刺点血肿2例(2.4%),尿潴留1例(1.2%).结论 脑血管造影术作为一项诊断技术对75岁以上脑血管病患者是较安全的,其并发症特别是永久性神经系统并发症的发生率较低.

关 键 词:脑血管障碍  脑缺血  脑血管造影术

Clinical analysis of cerebral angiography in patients 75 years or older with cerebrovascular diseases
HAN Yi-peng,WANG Da-ming,LIU Jia-chun,WANG Li-jun,LU Jun,QI Peng.Clinical analysis of cerebral angiography in patients 75 years or older with cerebrovascular diseases[J].Chinese Journal of Geriatrics,2010,29(5).
Authors:HAN Yi-peng  WANG Da-ming  LIU Jia-chun  WANG Li-jun  LU Jun  QI Peng
Abstract:Objective To analyze the angiography procedure,distribution of cerebral vascular lesions and complications of cerebral angiography in patients 75 years or older with cerebrovascular diseases.Methods A total of 83 consecutive patients 75 years or older (range 75-89 years) diagnosed as cerebral vascular diseases underwent cerebral angiography with a coverage of all arteries supplying blood to the whole brain including bilateral subclavian arteries between June 2003 and June 2009.The angiogram showed 61 patients (73.5%) with ischemic cerebralvascular diseases,22patients (26.5%) with hemorrhagic cerebralvascular diseases.Results The 78 (94.0%)angiographies were performed using transfemoral access.Composite curve catheters such as Simmons curve were selected in 11 (13.3%) angiographies.In patients with ischemic cerebralvascular diseases,159 stenotic lesions were detected,among which 107 (67.3%) lesions located at the anterior circulation and 52 (32.7%) lesions located at the posterior circulation;97 (61.0%) lesions were extracranial and 62 (39.0%) lesions were intracranial.The 9 unruptured aneurysms were incidentally detected in 8 patients.In patients with hemorrhagic cerebralvascular diseases,19 aneurysms were detected in 16 (72.6 % ) patients.Complications occurred in 5 (6.0 % ) patients:transient neurological complications occurred in 2 (2.4%) patients,hematoma at the puncture site occurred in 2 (2.4%)patients and uroschesis occurred in 1 (1.2%) patients.Conclusions As a kind of diagnostic technology,cerebral angiography is safe in patients 75 years or older with cerebral vascular diseases.The incidence of complications especially permanent neurological complications is low.
Keywords:Cerebrovascular disorders  Brain ischemic  Cerebral angiography
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