颅内动脉狭窄支架成形术临床相关性因素评估研究

目的探讨颅内动脉狭窄支架成形术的临床应用和相关并发症的影响因素。方法22例25支颅内大动脉段狭窄，行血管内支架成形术。其中大脑中动脉（MCA）15支，椎动脉（VA）5支，基底动脉（BA）3支和颈内动脉（ICA）2支。21支血管（MCA14支，BA2支，VA3支和ICA2支）为症状性重度狭窄、1支（BA）为无症状性重度狭窄；3支血管（MCA1支和VA2支）为症状性中度狭窄。比较评价支架成形术相关性效／损比、总体预后等方面的临床影响因素。结果技术成功率96％（24／25），手术死亡率0％，未发生再灌注损伤，9例随访者（6～27个月）无再狭窄；所有患者均无手术相关性并发症。结论对于具有治疗适应证的颅内动脉狭窄实施支架成形术是有效和安全的，但远期预后还有待于进一步评估。

Study on the related clinical factors of stenting for intracranial artery stenosis

Objective To discuss the clinical applications and the factors related to the complications of stenting for intracranial artery stenosis. Methods A total of 25 cases of large intracranial artery stenosis in 22 patients were treated by stenting. There were 15 cases of middle cerebral arteries （MCA）, 5 cases of vertebral arteries （VA）, 3 cases of basilar arteries （BA） and 2 cases of internal carotid arteries （ICA）. Among all the branches with stenosis, symptomatic severe stenosis presented in 21 vessels （14 MCA, 3 VA, 2 BA and 2 ICA）, nonsymptomatic severe stenosis in 1 vessel （BA） and symptonatic middle stenosis in 3 vessels （1 MCA and 2 VA）. Clinical impact of stenting and total prognosis were compared and evaluated. Results Total technical success rate was 96% （24/25） with no case of death and hyperperfusion syndrome. No restenosis occurred in 9 cases during follow-up （6 to 27 months）. There was no treatment-related complications in all cases. Conclusion It is effective and safe to treat the patients with intracranial artery stenosis indicative of vascular stenting, but prognosis for a long term needs further study.