锁骨下动脉起始段狭窄与闭塞的血管内治疗  

Endovascular treatment for subclavian arterial stenosis or occlusion

作　　者：秦碧勇[1] 陈光辉[1] 席刚明[1] 

机构地区：[1]湖北医药学院附属人民医院神经内科,湖北十堰442000

出　　处：《实用医院临床杂志》2011年第1期63-64,共2页Practical Journal of Clinical Medicine

摘　　要：目的探讨应用血管内支架治疗锁骨下动脉起始段狭窄或闭塞的有效治疗方法。方法局麻下，以Seldinger技术穿刺股动脉，置入8F导管鞘，全身肝素化，用5F Pigtail导管、单弯导管行主动脉弓及全脑血管造影。将8F导引导管置于病变锁骨下动脉近端，选择合适球囊扩张狭窄部位。撤出球囊导管，将支架递送系统沿导丝送入狭窄段，路图下准确定位并释放支架。对于锁骨下动脉闭塞患者，将8F导引导管置于闭塞锁骨下动脉近端，用泥鳅导丝小心反复试探至通过闭塞段，再重复上述步骤。若导丝始终不能通过闭塞段，则行肱动脉逆行穿刺，置入7—8F导管鞘，用泥鳅导丝在单弯管配合下小心反复试探逆行开通闭塞段，同法行逆行球囊扩张与支架置入。结果15例成功植入支架，1例未成功；支架植入后所有患者肱动脉及桡动脉搏动良好，临床症状改善；成功植入支架的15例中有1例12个月后再狭窄，再次植入1枚支架，其余患者随访24个月未见再狭窄；所有患者围手术期未见与手术有关的并发症。结论应用血管内支架治疗锁骨下动脉狭窄或闭塞是一种微创、安全、有效的治疗方法，有望成为主要的治疗手段。Objective To evaluate the clinical effect of endovascular stent for proximal subclavian arterial stenosis or occlusion. Methods Clinical data of 16 patients with proximal subclavian arterial stenosis or occlusion implanted intravascular stents were analyzed. Results Stents were successfully implanted in 15 cases and failed in one case. Brachial artery pulse and radial artery pulse recovered in all patients after stenting. Clinical symptoms of all patients were well improved. The patient who was found restenosis 12 months after stent implantation underwent re-implantation. Restenosis didn＇t occur in any other patients during the 24-month follow-up. No related complications were found in perioperatlve period. Conclusion Intravascular stenting is safe, effective and micro-invasive and is expected to become the main treatment for proximal subclavian artery stenosis or occlusion.

关 键 词：锁骨下动脉 狭窄 闭塞 支架 介入治疗 

分 类 号：R543.5[医药卫生—心血管疾病]