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目的总结Wingspan支架治疗重度症状性颅内椎-基底动脉狭窄的经验。方法回顾性分析30例共31处重度症状性椎-基底动脉狭窄病人的临床资料。所有病人均经Wingspan治疗,通过改良Rankin评分(modified ranking scale,MRS)和美国国家卫生院脑卒中量表(national institutes of health stroke scale,NIHSS)进行临床评估。结果手术成功率100%,血管平均狭窄度由术前(82.3±8.0)%降至(11.2±7.3)%,手术前后狭窄度经统计学分析有显著差异(P<0.05)。围手术期并发症包括脑桥梗死2例和支架叠加导致一过性血流灌注不足1例。临床随访27例,时间5~40个月。影像学随访19例,时间5~20个月。1例发生症状性再狭窄,其他无再狭窄和缺血事件。结论 Wingspan支架植入是药物治疗无效的颅内血管狭窄的有效、安全的方法,但需注意围手术期并发症的防治,对远期结果有待进一步观察。
Objective To summarize the experience of Wingspan stent in the treatment of severe symptomatic intracranial vertebral-basilar artery stenosis. Methods The clinical data of 30 patients with severe symptomatic vertebro-basilar artery stenosis in 30 patients were retrospectively analyzed. All patients were treated with Wingspan and were evaluated clinically by a modified rankings scale (MRS) and the National Institutes of Health stroke scale (NIHSS). Results The success rate of operation was 100%. The mean vascular stenosis decreased from (82.3 ± 8.0)% to (11.2 ± 7.3)% preoperative and postoperative. The stenosis degree before and after operation was significantly different (P <0.05). Perioperative complications including pontine infarction in 2 cases and stent superimposed lead to transient perfusion in 1 case. Clinical follow-up of 27 cases, the time of 5 to 40 months. Imaging follow-up in 19 cases, the time of 5 to 20 months. 1 case of symptomatic restenosis, no other restenosis and ischemic events. Conclusion Wingspan stent implantation is an effective and safe method for the treatment of intracranial vascular stenosis which is ineffective in drug treatment. However, it is necessary to pay attention to the prevention and treatment of perioperative complications, and the long-term results need to be further observed.