血管内介入治疗锁骨下动脉盗血综合征临床研究  

A Clinical Study of Endovascular Treatment for Subclavian Steal Syndrome

作　　者：胡华[1] 刘锋昌 范凯[1] 腾国良 刘建林[2] HU Hua LIU Feng- chang FAN Kai TENG Guo-liang LIU Jian-lin(Department of Neurology, Xi＇an North Hospital, Xi＇an 710043, China Department of Vascular Surgery, the First Affiliated Hospital of Xi＇an Jiaotong University, Xi＇an 710061, China)

机构地区：[1]西安市北方医院神经内科,710043 [2]西安交通大学第一附属医院血管外科,710061

出　　处：《中国临床神经科学》2016年第6期627-634,677,共9页Chinese Journal of Clinical Neurosciences

摘　　要：目的探讨应用血管内介入治疗锁骨下动脉盗血综合征的有效性和安全性。方法回顾性分析53例经血管内介入的锁骨下动脉盗血综合征患者的临床资料,从手术成功率、手术并发症及术后随访情况观察血管内介入治疗的有效性和安全性。结果 45/53例(84.90%)锁骨下动脉狭窄患者和8/53例(15.09%)完全锁骨下动脉闭塞患者均成功进行了血管内介入治疗,术后症状明显缓解。53例患者中发生手术并发症5次(9.43%),但未出现神经功能缺损和危及生命的手术并发症。锁骨下动脉闭塞的手术并发症发生率(37.50%)较锁骨下动脉狭窄(4.44%)显著升高(P<0.05)。随访50/53例患者,随访率94.34%,平均随访时间(18.6±1.2)个月。1例患者术后12个月再狭窄率超过90%,行二次球囊成型;其余患者预后良好。结论应用血管内介入治疗锁骨下动脉盗血综合征具有微创、安全、高效优点,可作为首选治疗方法。Aim To explore the efficacy and safety of endovasular therapy in the treatment of subclavian steal syndrome. Methods 53 patients with subclavian steal syndrome treated by endovascular intervention were reviewed in this study. Various clinical parameters such as the success rate, complications and postoperative follow-up results were analyzed to observe the efficacy and safety of endovascular treatment. Results 45 patients（84.90%） with subclavian artery stenosis and 8 patients（15.10%） with subclavian artery occlusion were successfully operated, and their symptoms were obviously alleviated after operation. In all the cases, complications occurred in 5 patients, as the total incidence of 9.4%. No neurological function defect and life-threatening complications occurred. The complication rate in patients with subclavian artery stenosis was about 4.4%, and it was about 37.5% in patients with subclavian artery occlusion, which was much higher than that in patients with subclavian artery stenosis（P〈0.05）. 50 cases in all the operated patients were followed up, as the follow-up rate of 94.33%, and the average followup duration was（18.6±1.2） months. One of the patients developed restenosis during the follow-up period, whose stenosis rate was greater than 90%, and he accepted a second balloon angioplasty. The rest of the patientshad favorable outcome. Conclusion As a minimally invasive surgery, endovascular interventional treatment is safe and effective, which could be feasible and safe choice in the treatment of subclaviant steal syndrome.

关 键 词：锁骨下动脉盗血综合征 介入治疗 支架 

分 类 号：R743[医药卫生—神经病学与精神病学]