球囊扩张支架与自膨式支架治疗症状性颅内动脉重度狭窄的比较  

Comparison of balloon-expandable stents and self-expanded stents in the treatment of severe symptomatic intracranial arterial stenosis

作　　者：童晨光[1,2] 李慎茂[1] 缪中荣[1] 焦力群[1] 朱凤水[1] 

机构地区：[1]首都医科大学宣武医院介入放射诊断治疗科,北京100053 [2]中国中医科学院西苑医院神内二科,100091

出　　处：《中国脑血管病杂志》2011年第1期13-17,共5页Chinese Journal of Cerebrovascular Diseases

基　　金："十一五"国家科技支撑计划项目 (2007BA105B04)

摘　　要：目的探讨应用冠状动脉球囊扩张支架和自膨式支架治疗症状性颅内动脉重度狭窄的差异。方法 2009年3-11月收治的症状性颅内动脉狭窄患者22例(23处病变,置入24枚支架),分别采用冠状动脉球囊扩张支架和自膨式支架进行血管内治疗,比较两种支架治疗颅内动脉重度狭窄的技术成功率、并发症以及近期预后。结果①采用冠状动脉球囊扩张支架治疗的共12例患者,13处病变,按照病变部位,位于前循环5处,后循环8处,按照Mori分型,A型8处,B型4处,C型1处;采用自膨式支架治疗的共10例患者,11处病变(其中1处病变联合使用自膨式支架和球囊扩张支架),位于前循环8处,后循环3处,其中Mori A型1处,B型5处,C型5处。②冠状动脉球囊扩张支架组的技术成功率为100%(13/13),1例Mori C型患者出现围手术期神经系统并发症。自膨式支架组的技术成功率为91%(10/11),1例死亡。③两组患者术后随访半年,均无短暂性脑缺血发作或卒中发作,TCD随访5例,冠状动脉球囊扩张支架组有1例发生无症状再狭窄(1/4)。结论两种支架治疗症状性颅内动脉重度狭窄均有效,且技术成功率、并发症发生率和近期预后相似。Objective To investigate the difference between coronary balloon-expandable stents and self-expanded stents in the treatment of severe symptomatic intracranial arterial stenosis. Methods Twentytwo patients （23 lesions with 24 stents） with symptomatic intracranial arterial stenosis admitted in the hospital from March 2009 to November 2009 were treated with coronary balloon-expandable stents and self-expanded stems respectively. The technical success rate, complications and short-term result of the two stent technologies in the treatment of severe symptomatic intracranial arterial stenosis were compared. Results （!）There were 13 lesions in 12 patients in the coronary balloon-expandable stent group, 5 lesions in the anterior circulation and 8 in the posterior circulation. Mori Type A, B and C lesions were detected in 8, 4 and 1 sites respectively. There were 10 patients （11 lesions, one lesion with self-expanding stents and combined with balloon-ex- pandable stents） in the self-expanded stem group, 8 lesions were in the anterior circulation and 3 were in the posterior circulation, in which Mori type A 1 site, type B 5 sites,and type C 5 sites. （2）The technical successful rate of the coronary balloon-expandable stent group was 100% （13/13）. One patient of Mori type C had perioperative neurological complication. The technical successful rate of the self-expanded stem group was 91% （10/11）. One patient died. （3）All the patients in both groups were followed up for 6 months, there were no transient ischemic attack （TIA） or stroke occured. Five patients were followed up with TCD. One had asymptomatic restenosis in the coronary balloon-expandable stent group. Conclusion Both kinds of stents are effective in the treatment of severe symptomatic intracranial arterial stenosis, and the technical successful rate, complication rate and short-term result are similar.

关 键 词：血管成形术 颈动脉狭窄 椎底动脉供血不足 支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]