Wingspan支架治疗症状性椎动脉颅内段和基底动脉狭窄的临床观察  

Wingspan stent for symptomatic intracranial vertebral artery and basilar artery stenosis

作　　者：许斌[1] 史怀璋[1] 徐善才[1] 季智勇[1] 吴培[1] 

机构地区：[1]哈尔滨医科大学附属第一医院神经外科,150001

出　　处：《中华神经外科杂志》2012年第12期1226-1229,共4页Chinese Journal of Neurosurgery

摘　　要：目的评估Gateway—Wingspan支架治疗症状性椎动脉颅内段和基底动脉狭窄患者的安全性和有效性。方法回顾性分析应用Gateway—Wingspan支架治疗39例症状性椎动脉颅内段和基底动脉狭窄患者的临床资料，观察围手术期情况及术后随访情况。结果39例患者共40处狭窄行血管内支架成形术，其中椎动脉颅内段9处，基底动脉31处。1例患者因支架到位困难，仅行球囊扩张。共成功置入Wingspan支架39枚，手术成功率98％（39／40）。术前平均狭窄率为（78．09±12．01）％，术后残留狭窄率为（16．53±12．59）％。4例发生围手术期并发症，发生率为10％（4／39），其中1例死亡，其余患者临床症状均有所好转。随访8—42个月，平均（25．0±10．8）个月，有2例出现症状性再狭窄（狭窄程度〉50％），其中1例是支架置入失败的患者。1例因肺部感染死亡。结论应用Gateway—Wingspan支架治疗椎动脉颅内段及基底动脉狭窄是安全有效的，长期疗效需进一步观察。Objective To study the safety and efficacy of the Gateway - Wingspan stent system as a treatment of symptomatic intracranial vertebral artery and basilar artery stenosis. Methods The clinical data of 39 patients, with symptomatic intracranial vertebral artery and basilar artery stenosis, treated by the Gateway- Wingspan stent system from February 2008 to December 2010 were studied retrospectively. Results 39 patients with 40 narrow - line stent angioplasty were performed, in which nine were in the intracranial vertebral artery and 31 were in the basilar artery. One patient＇s operation was performed only with balloon angioplasty because the stent was difficult to be placed. 39 Wingspan stent was successfully implanted with a 98% （39/40） surgical success rate. The mean preoperative stenosis rate was （78. 09 ± 12. 01）%. The postoperative residual stenosis rate was （16. 53 ±12. 59）%. Four patients had perioperative complications （10%, 4/39 ）. One patient died. The remaining patients had improved symptoms. During the follow -up period, from 8 to 42 months （average 25.0 ± 10. 8 months）, 2 patients had symptomatic restenosis （stenosis rate 〉 50% ）. One of them was the patient who did not successfully receive an implanted stent. One patient died from lung infection. Conclusions The application of the Gateway -Wingspan stent system for treating intracranial vertebral artery and basilar artery stenosis is safe and effective. Longterm efficacy needs further observation.

关 键 词：支架 椎动脉颅内段 基底动脉 狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]