应用Enterprise支架治疗动脉粥样硬化性椎-基底动脉狭窄的探讨  

Application of enterprise stent in atherosclerotic vertebral-basilar arterial stenosis

作　　者：王小飞[1] 王成伟[1] 王志刚[1] 丁璇[1] 王敏卿[1] 

机构地区：[1]山东大学第二医院神经外科,山东济南250033

出　　处：《山东大学学报（医学版）》2015年第8期44-48,共5页Journal of Shandong University:Health Sciences

摘　　要：目的探讨应用Enterprise支架治疗动脉粥样硬化性椎-基底动脉狭窄的安全性和有效性。方法回顾性分析2012年1月至2014年6月山东大学第二医院神经外科应用Enterprise支架治疗动脉粥样硬化性椎-基底动脉狭窄患者46例,患者术前至少提前3 d服用氯吡格雷（75 mg/d）和阿司匹林（300 mg/d）联合抗血小板治疗。记录患者各项临床指标,并于术后1、3、6、12个月进行临床及脑血管造影随访。结果46例患者共计48处狭窄病变。其中男33例（71.7%）,女13例（28.3%）。病变位于基底动脉28处（58.3%）,左侧椎动脉15处（31.3%）,右侧椎动脉5处（10.4%）。病变血管狭窄程度50%～70%共6处（33.3%）,70%～99%共32处（66.7%）。手术成功率100%。围手术期并发症4例（8.7%）。术后6个月,35处病变获得造影随访,其中术后支架内再狭窄5例（14.3%）。随访期发生与病变血管供血区一致的缺血事件5例（10.9%）。结论应用Enterprise支架治疗动脉粥样硬化性椎-基底动脉狭窄安全有效,技术成功率高,并发症发生率较低。Objective To assess the safety and efficacy of enterprise stent in the treatment of atherosclerotic vertebralbasilar arterial stenosis. Methods A retrospective study was performed in patients who received enterprise stent in the Department of Neurosurgery,Second Hospital of Shandong University during Jan. 2012 and June 2014. Patients were prescribed with medication of clopidogrel 75 mg /d and aspirin 300 mg /d at least 3 days preoperatively. The observation indexes,clinical follow-ups and digital subtraction angiography（ DSA） performed in month 1,3,6 and 12 postoperatively were collected and reviewed. Results Of the 46 patients with 48 lesions,33（ 71. 7%） were men and 13（ 28. 3%） were women,28 lesions（ 58. 3%） were at the basilar artery,15（ 31. 3%） were at the left vertebral artery,and 5（ 10. 4%） were at the right vertebral artery. The technical success rate was 100%. Altogether 4 patients（ 8. 7%）developed perioperative complications. DSA examination of 35 lesions 6 months postoperatively showed 5 cases（ 14. 3%） had postoperative restenoses. And 5（ 10. 9%） ischemic events occurred during the follow-up. Conclusion Application of enterprise stent is safe and efficacious,with high technical success rate and low perioperative complication rate.

关 键 词：颅内支架 动脉粥样硬化 椎-基底动脉 狭窄 介入治疗 

分 类 号：R651.1[医药卫生—外科学]