经肱动脉行同侧椎动脉支架成形术治疗椎动脉狭窄的可行性分析  

Study on the feasibility analysis of ipsilateral vertebral artery stenting via brachial artery in the treatment of vertebral artery stenosis

作　　者：周琳[1] 唐维国[1] 管姝轶[1] 孙茂军[1] 王斌达[1] 寇雪莲[1] 戴方瑜[1] ZHOU Lin;TANG Weiguo;GUAN Shuyi;SUN Maojun;WANG Binda;KOU Xuelian;DAI Fangyu(Department of Neurology, Zhoushan Hospital in Zhejiang Province, Zhoushan 316004, China)

机构地区：[1]浙江省舟山医院神经内科,浙江舟山316004

出　　处：《中国现代医生》2018年第4期1-4,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划(2014ZDA026);浙江省舟山市医药卫生科技计划(2014A12)

摘　　要：目的总结我院15例经肱动脉行同侧椎动脉支架成形术的经验,评估其可行性、安全性及成功率,为临床中进行椎动脉支架成形术提供一个新的手术入路。方法选取同期存在行椎动脉支架成形术治疗指征的患者共30例,按入路血管分为经肱动脉入路组及经股动脉入路组,各15例。比较两组椎动脉狭窄改善情况、穿刺成功率、手术成功率及并发症发生率。结果两组患者均顺利进行椎动脉支架植入术,两组穿刺成功率均为100%,手术成功率均为100%,差异无统计学意义(P>0.05)。两组患者术中支架膨胀均良好,术后狭窄处血管改善情况均良好。且术后两组患者均无一例发生穿刺部位血肿。经肱动脉入路组术前椎动脉平均狭窄率为86.7%,术后下降至6.7%;经股动脉入路组术前平均狭窄率为73.3%,术后下降至6.7%。两组手术前后差异均有统计学意义(P<0.01),且术后存在的狭窄均<10%。结论经肱动脉行同侧椎动脉支架植入术这一入路方式安全可行,手术成功率高,可作为新的血管介入方式进行介入治疗。Objective To summarize the experience of15cases undergoing ipsilateral vertebral artery stenting via brachial artery in our hospital,and to evaluate the feasibility,safety and success rate,so as to provide a new surgical approach for vertebral artery stenting in clinical treatment.Methods A total of30patients with the treatment indicator of vertebral artery stenting during the same period were selected.According to the approaches of blood vessels,the patients were divided into the trans-brachial artery approach group and the trans-femoral artery approach group(15cases in each group).The improvement of vertebral artery stenosis,puncture success rate,operation success rate and complication rate were compared.Results Two groups of patients were successfully given vertebral artery stent implantation.The puncture success rate was100%,and the operation success rate was100%in both groups.There was no statistical difference(P>0.05).The intraoperative stent expansion was favorable in both groups,and the postoperative stenosis vascular improvement were favorable.No one in the two groups had postoperative hematoma at the puncture site.The preoperative average stenosis rate of the vertebral artery in the brachial artery approach group was86.7%,and was decreased to6.7%postoperatively.The average preoperative stenosis rate was73.3%in the femoral artery approach group,and was decreased to6.7%postoperatively.The differences between before and after surgery in the two groups were statistically significant(P<0.01),and the postoperative stenosis was<10%.Conclusion The approach of ipsilateral vertebral artery stenting via brachial artery is safe and feasible,with high success rate of surgery,which can be used as a new vascular interventional approach.

关 键 词：肱动脉 股动脉 椎动脉 椎动脉支架成形术 路径 

分 类 号：R743.3[医药卫生—神经病学与精神病学]