血管内支架置入术治疗椎-基底动脉延长扩张症  

Endovascular reconstruction for vertebrobasilar dolichoectasia

作　　者：吴曦[1] 黄清海[1] 杨鹏飞[1] 洪波[1] 许奕[1] 赵文元[1] 刘建民[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：《中国脑血管病杂志》2010年第7期350-353,359,共5页Chinese Journal of Cerebrovascular Diseases

基　　金：上海市自然科学基金资助项目(08ZR1404200);上海市优秀学科带头人项目(07XD14026);上海市科委重点项目(074119506)

摘　　要：目的探索使用血管内支架技术治疗椎-基底动脉延长扩张症(VBD)的可行性、有效性和安全性。方法回顾性分析2004年1月—2010年1月,上海第二军医大学长海医院神经外科采用血管内支架置入术治疗的5例VBD患者。结果①5例患者中,VBD合并椎-基底动脉急性夹层1例,VBD合并椎动脉动脉瘤1例,VBD引起三叉神经痛1例,VBD致后循环缺血、梗死2例。②每例VBD患者平均置入3(1～5)枚LEO支架和3.8(0～8)枚弹簧圈,重建椎-基底动脉的血流。③所有患者血管重建成功,术后症状均明显改善,未出现手术相关并发症。5例患者平均随访9.2(2～17)个月,无新发临床症状。结论弹簧圈辅助支架治疗VBD在技术上具有可行性,安全性较好,可显著改善VBD引起的多种临床症状,但对卒中的长期预防效果尚有待进一步研究。Objective To explore the feasibility, efficacy and safety of using intravascular stent placement in the treatment of vertebrobasilar dolichoectasia （VBD）. Methods The clinical data of 5 patients with VBD treated with the intracranial stent placement in the Department of Neurosurgery, Changhai Hospi- tal, the Second Military Medical University, Shanghai, China from January 2004 to January 2010 were ana- lyzed retrospectively. Results （1）All the 5 patients met the CT and other diagnostic criteria of VBD. They were diagnosed definitely after DSA examination. One of them had VBD with acute vertebrobasilar dissection, 1 had VBD with vertebral artery aneurysm, 1 had VBD caused trigeminal neuralgia, and 2 had VBD caused posterior circulation isehemia and infarction.（2）The mean 3 （ 1 to 5） LEO stents and 3.8 （0 to 8） coils were placed in each patient with VBD for reconstruction of the vertebrobasilar artery blood flow. （3）The revaseularization was successful in all the patients, and their symptoms were improved significantly. There were no pro- cedure-related complications. The mean follow-up time of the 5 patients were 9.2 （2 to 17 ） months, and they did not have any newly developed clinical symptoms. Conclusion The treatment of VBD with stent- assisted coil embolization is safe and technically feasible. It may significantly improve VBD caused clinical symptoms. However, its effect on long-term prevention of stroke remains to be further studied.

关 键 词：椎基底动脉延长扩张症 颅内动脉瘤 支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]