药物洗脱支架治疗椎动脉起始段狭窄  

Drug - eluting stent for the treatment of symptomatic vertebral origin stenosis

作　　者：陈鑫璞[1] 刘建民[1] 黄清海[1] 洪波[1] 许奕[1] 赵文元[1] 赵瑞[1] 

机构地区：[1]第二军医大学附属长海医院神经外科,上海200433

出　　处：《中华神经外科杂志》2010年第2期100-103,共4页Chinese Journal of Neurosurgery

基　　金：上海市科委重点项目（074119506）

摘　　要：目的评价药物洗脱支架治疗椎动脉起始段狭窄的安全性及中、长期疗效。方法回顾分析47例采用药物洗脱支架成形术治疗椎动脉起始段狭窄病例资料、术后临床和影像学随访结果。结果47例患者椎动脉单侧狭窄41例，双侧狭窄6例；同侧椎动脉串联狭窄2例，BX支架术后再狭窄1例，并存其他部位动脉狭窄17例。先后共治疗椎动脉起始段狭窄49处。椎动脉起始段术前、术后平均狭窄程度分别为72％和9％。无手术并发症。术后临床症状消失11例，症状改善30例，症状无变化6例。所有病例术后临床随访2—48个月，平均28．3个月，2例患者再发后循环缺血性事件。28例（59％）血管造影随访3—34个月，平均12．2个月，2例发生支架内再狭窄，其中1例为症状性；4例无症状性支架断裂。结论中长期随访结果显示药物洗脱支架治疗椎动脉起始段狭窄是安全有效的，支架内再狭窄率明显低于裸支架。Objective To evaluate mid- long outcomes of drug -eluting stent（DES） for vertebral artery origin stenosis. Methods The demographics, indications for treatment, procedural technique, and clinical and radiographic follow - up were analyzed retrospectively in 47 consecutive patients treated with drug - eluting stents. Results 47 patients with 49 lesions were successfully treated with stent. No peri - procedural complications occurred. The mean degree of stenosis reduced from 72% to 9%. Symptoms were resolved in 11 cases, improved in 30 cases, unchanged in 6 cases. During follow - up for 2 - 48 months （mean 28. 3 months）, tow cases had posterior circulation transient ischemic attack （TIA）. Angiographic fowllow - up of 3 - 34 months was obtained in 28 patients （ 59% ） with a mean of 12. 2 months. Restenosis inside the stent （IRS） was observed in 2 patients and one present with drop attack. Stent fracture occurred in 4 patients, in which 2 cases with IRS. Conclusions VA origin stenosis can be treated safely and effectively with DES. Compared with the bare stent, DES can significantly reduces the rates of restenosis.

关 键 词：椎动脉狭窄 椎底动脉供血不足 后循环缺血 血管成形术 支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]