经皮血管内支架治疗锁骨下动脉狭窄性疾病

目的探讨应用血管内支架治疗锁骨下动脉狭窄或闭塞性疾病的疗效。方法回顾分析10例11支锁骨下动脉狭窄或闭塞病变行血管内介入治疗的临床资料。结果10例8支锁骨下动脉狭窄病变(狭窄率大于70%)成功置入支架,3支闭塞锁骨下动脉中1支成功置入支架,2支闭塞锁骨下动脉未能开通。7例经股动脉置入支架,1例经肱动脉逆行置入支架。锁骨下动脉支架成功置入后肱动脉及桡动脉搏动良好,伴有盗血现象的5例患者症状消失。随访2～24个月发现1例锁骨下动脉支架置入后9个月再狭窄,后再置入1枚支架,血管开通良好。1例患者双侧锁骨下动脉狭窄同时置入2枚支架后2个月突发脑出血死亡。结论应用血管内支架治疗锁骨下动脉狭窄或闭塞是一种微创、安全、有效的治疗方法,有望成为主要的治疗手段。

Pecutaneous intravascular stenting for subclavian arterial stenosis or occlusion

Objective To evaluate the clinical effects of intravascular stenting for subclavian arterial stenosis or occlusion. Methods Retrospective analysis of the clinical data for 10 patients with subclavian arterial stenosis or occlusion utilizing intravascular stents. Results Eight subclavian arterial stenosis or occlusion lesions in 10 patients were placed stents successfully(stenosis > 70%). One of the 3 subclavian arterial occlusions was also successfully with stent placement but the other 2 were given up due to the failure of passing through the guidewrie. Seven with stenting through femoral artery and 1 through retrograde brachial arterial approach, showed well brachial and radial arterial pulsations after the procedure, together with the vanishment of "stealth" sign in 5 patients. During 2 - 24 months follow-up, 1 case occurred restenosis 9 months later, and was restented with uneventful repatency. The case with two stents placed at the same time in bilateral subclavian arteries died suffering from cerebral hemorrhage 2 months later after stenting. Conclusions Intravascular stenting is safe, effective and mini-invasive in treating subclavian artery stenosis or occlusion, expecting to be the most crucial clinical therapy.