症状性锁骨下动脉狭窄或闭塞的腔内治疗效果分析

目的 探讨症状性锁骨下动脉窃血综合征患者血管腔内技术治疗的临床有效性和安全性。方法 选取首都医科大学附属北京朝阳医院血管外科2011年1月至2015年8月收治的症状性锁骨下动脉狭窄或闭塞患者38例，其中男27例，女11例；平均年龄为（66.2±10.8）岁。患者均表现为头晕等神经系统症状，部分合并上肢缺血症状。运用血管腔内技术，对锁骨下动脉进行球囊扩张成形及支架植入术。结果 36例患者均成功植入球扩式支架，术后双上肢收缩压差显著改善，神经系统症状消失或改善33例，无效2例，1例术中发生脑梗死，经康复锻炼后好转；2例操作没成功，保守治疗。随访期间再狭窄3例，支架断裂1例。结论 严格掌握适应证，采用腔内技术治疗锁骨下动脉狭窄或闭塞的神经系统症状安全有效，操作简单。

Clinical efficiency of endovascular treatment for symptomatic subclavian artery stenosis or occlusion

Objective To evaluate the clinical safety and efficiency of endovascular treatment for subclavian artery stenosis or occlusion. Methods Totally 38 patients suffering from symptomatic subclavian artery stenosis or occlusion in our department from January 2011 to August 2015 were recruited in this study. They were 27 males and 11 females, at a mean age of (66.2±10.8) years. All of them presented the neurological symptoms such as dizziness, and some were accompanied by symptoms of upper limb ischemia. Percutaneous transluminal angioplasty and stent implantation were applied to them. Their clinical data and outcomes were collected and analyzed to evaluate the efficiency of the treatment. Results There were 36 cases successfully receiving balloon-expandable stent implantation. Their right- and left-arm blood pressure discrepancies were improved after treatment. The preoperative neurological symptoms were improved or disappeared in 33 patients after the procedures, but unchanged in 2 patients. Cerebral infarction occurred in 1 case during the interventional procedure, and the patient was recovered after thrombolysis and rehabilitation training. The operation did not succeed in 2 cases, and they were given conservative treatment. There were 3 patients having restenosis and 1 having stent fractured during the follow-up. Conclusion Under strict indications, endovascular intervention is safe, effective and easy to operate in the treatment of subclavian artery stenosis or occlusion with neurological symptoms.