支架置入治疗椎-基底动脉延长扩张症安全性和有效性的初步观察  

Preliminary observation of safety and effectiveness analysis of vertebrobasilar dolichoectasia treated with stent implantation

作　　者：何旭英[1] 段传志[1] 张剑波 曾文贤 李振均 李西锋[1] He Xuying;Duan Chuanzhi;Zhang Jianbo;Zeng Wenxian;Li Zhenjun;Li Xifeng(Department of Neurosurgery,Zhujiang Hospital of Southern Medical University,Guangzhou 510282,China)

机构地区：[1]南方医科大学珠江医院神经外科,广州510282

出　　处：《中国脑血管病杂志》2018年第9期483-488,共6页Chinese Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金资助项目(81400943)

摘　　要：目的分析支架置入治疗椎-基底动脉延长扩张症(VBD)的安全性及有效性。方法回顾性分析2016年7月至2018年3月南方医科大学珠江医院神经外科连续收治的采用血管内支架置入术治疗的7例VBD患者的临床及影像学资料。7例患者均置入1～3枚直径最大的LEO支架(5.5 mm×75.0 mm或5.5 mm×50.0 mm),1例患者联合置入Solitaire支架,3例患者联合置入微弹簧圈。治疗3个月后均进行DSA及MRI随访。结果 6例患者术中及术后未发生并发症,术后2周临床症状均有改善;1例患者术中发生大脑后动脉血栓形成,给予溶栓及支架置入后血管再通。DSA影像随访均有修复,短期随访临床症状改善,但MRI的复查结果示血管外血栓未见明显变化;2例患者远期随访,吞咽困难有加重,其中1例新发脑积水。结论支架置入治疗VBD短期可取得很好的影像及临床效果,但对占位引起的临床症状,长期疗效仍不确切。Objective To analyze the safety and effectiveness of vertebrobasilar dolichoectasia（ VBD） treated with large stent implantation. Methods From July 2016 to March 2018,the clinical and imaging data of 7 consecutive patients with VBD treated with large stent implantation at the Department of Neurosurgery,Zhujiang Hospital of Southern Medical University were analyzed retrospectively. 1 to 3 largest LEO stents（ 5. 5 mm × 75. 0 mm or 5. 5 mm × 50. 0 mm） were implanted in 7 patients. One patient also implanted Solitaire stents,3 were also implanted microcoils. After 3 months of treatment,they were all followed up by DSA and MRI. Results No complications occurred in 6 patients during operation and after procedure,and all the clinical symptoms were improved 2 weeks after procedure. posterior cerebral artery thrombosis occurred in 1 patients during operation. After giving thrombolysis and stent implantation,his blood vessel was recanalized. The DSA follow-up found that VBD was all repaired. Short-term follow-up showed improvement in clinical symptoms,but the MRI findings showed no significant changes in extravascular throm bosis. D ysphagia w as aggravated in long-term follow-up in 2 patients,1 of them had new hydrocephalus. C onclusion Large stent implantation for the treatment of VBD achieves good shortterm imaging and clinical effects,but the long-term efficacy of clinical symptoms caused by space occupying is still uncertain.

关 键 词：椎-基底动脉延长扩张症 支架 安全性 有效性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]