血管内支架成形术治疗颅内动脉狭窄的临床研究  

Clinical study of endovascular stenting for intracranial artery stenosis

作　　者：朱凤磊[1,2] 肖国栋[3] 高海宁[1] 翟登月[1] 徐格林[1] 殷勤[1] 朱武生[1] 刘新峰[1] 

机构地区：[1]第二军医大学南京临床医学院(南京军区南京总医院)神经内科,南京210002 [2]第二军医大学 [3]苏州大学第二附属医院神经内科

出　　处：《临床神经病学杂志》2009年第3期161-163,共3页Journal of Clinical Neurology

基　　金：国家自然科学基金(30870847)

摘　　要：目的评价血管内支架成形术治疗颅内动脉狭窄的有效性和安全性。方法39例颅内动脉狭窄患者根据数字减影全脑血管造影（DSA）检查分为前循环组[26例，11例为短暂性脑缺血发作（TIA），15例为脑梗死（CI）]和后循环组（13例，3例为TIA，10例为CI），并给予血管内支架成形术治疗；比较两组手术成功率、术后动脉狭窄改善率及并发症发生率；随访6～12个月，复查DSA；比较手术前、后CI患者改良Rankin量表（mRS）评分和Barthel指数（BI）的变化。结果前后循环组手术成功率分别为92．3％和100％，术后动脉狭窄改善率均〉70％，并发症发生率分别为19．2％和7．7％，两组间差异无统计学意义；随访期间前循环组10例、后循环组5例复查DSA，两组各有1例出现动脉再狭窄50％；术后6个月及12个月两组CI患者mRS评分、BI均较术前显著改善（均P〈0．05）；两组均无TIA及CI发生。结论血管内支架成形术可明显改善颅内动脉狭窄，降低脑血管事件的发生，安全有效。Objective To evaluation the efficacy and safety of endovascular stenting for intracranial artery stenosis. Methods By the checking of DSA, 39 patients with intracranial artery stenosis were divided into the anterior circulation group [ 26 cases, including 11 cases of transient ischemic attack （TIA）, 15 cases of cerebral infarction（CI） ] and posterior circulation group （13 cases, including 3 cases of TIA, 10 cases of CI）. All the patients were treated with endovascular stents. The rates of the stenting success, improvement rate of stenosis poststenting and incidence of complications were compared between the two groups. In 6 -12 months follow-up, DSA reexamination was performed, and the scores of mRS and BI in patients with CI between pre and post-stenting were compared. Results The rate of stenting success in anterior circulation group was 92.3%, and 100% in posterior circulation group. The improvement rates of stenosis compared pre-stenting in the two groups were all above 70% . The incidence of complications was 19.2% in anterior circulation group and 7.7% in posterior circulation group. There was no statistical difference between the two groups. There were 10 cases in anterior circulation group and 5 cases in posterior circulation group received DSA reexamination, and 50% restenosis was found in the 2 cases （ 1 case in each group）. In the period of the follow-up, the score of mRS and BI at the 6 months and 12 months poststenting of patients with CI were significant improved than pre-stenting （ all P 〈 0. 05 ）. There was no TIA and CI occurred in the two groups. Conclusion The endovascular stents is a safe and effective method for improving intracranial artery stenosis, and decreasing the incidence of cerebrovascular events.

关 键 词：颅内动脉狭窄 支架成形术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]