双侧颈动脉狭窄或闭塞性病变的侧支循环途径  

Collateral circulation pathways in patients with bilateral carotid stenosis/occlusive lesions

作　　者：车飞[1] 侯备 付金霞[1] 王楠楠[1] 黄艾华 王佳楠 Che Fei;Hou Bei;Fu Jinxia;Wang Nannan;Huang Aihua;Wang Jianan(Diagnosis and Interventional Treatment Center of Cerebrovascular Diseases,Affiliated No.2 Hospital of Qiqihar Medical University,Qiqihar 161006,Heilongjiang Province,China)

机构地区：[1]齐齐哈尔医学院附属第二医院脑血管狭窄诊断与介入治疗中心,161006 [2]火箭军特色医学中心神经内科

出　　处：《中华老年心脑血管病杂志》2020年第11期1140-1143,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：黑龙江省省属高等学校基本科研业务费科研项目(2019-KYYWF-1222)。

摘　　要：目的探讨双侧颈动脉狭窄/闭塞性病变患者的侧支循环代偿途径。方法选择双侧颈动脉狭窄/闭塞性病变患者10例,收集患者临床、影像及血流动力学资料,评估双侧颈动脉发生狭窄/闭塞性病变后启动的侧支循环及具体代偿途径。结果双侧颈内动脉闭塞3例(30.0%)、一侧(左侧)颈总动脉(CCA)闭塞合并对侧颈内动脉重度狭窄1例(10.0%)、一侧颈内动脉闭塞合并对侧颈内动脉重度狭窄5例(50.0%)、双侧CCA重度狭窄合并一侧(左侧)颈内动脉重度狭窄1例(10.0%)。启动的侧支循环代偿途径:前交通动脉侧支7例、后交通动脉侧支2例、眼动脉侧支3例、软脑膜吻合侧支6例、胼周动脉吻合侧支1例、颈外动脉-枕动脉-硬脑膜动脉-大脑中动脉软脑膜吻合侧支1例、颈内动脉-脉络膜前动脉-新生烟雾血管1例、颈内动脉窃血1例,共8种代偿途径。结论双侧颈动脉狭窄/闭塞性病变患者因病变情况不同可启动包含一、二、三级侧支循环的不同代偿途径。Objective To study the collateral circulation compensatory pathways in patients with bilateral carotid stenosis/occlusive lesions.Methods Ten patients with bilateral carotid stenosis/occlusive lesions were included in this study.Their clinical,imaging and hemodynamic data were recorded.The collateral circulation and its specific compensatory pathways in patients with bilateral carotid stenosis/occlusive lesions were assessed.Results Of the 10 patients included in this study,3(30.0%)were diagnosed with bilateral internal carotid stenosis/occlusion,1(10.0%)was diagnosed with unilateral common carotid artery occlusion complicated with severe opposite internal carotid artery stenosis,and 5(50%)were diagnosed with unilateral internal carotid artery occlusion complicated with severe opposite internal carotid artery stenosis.Eight collateral circulation compensatory pathways were detected in the 10 patients,including anterior communicating artery collateral branch in 7 patients,posterior communicating artery collateral branch in 2 patients,ophthalmic artery collateral branch in 3 patients,leptomeningeal anastomotic collateral branch in 6 patients,pericallosal artery anastomotic collateral branch in 1 patient,external carotid artery-occipital artery-dural artery-middle cerebral artery piamatral anastomotic collateral branch in 1 patient,internal carotid artery-choroidal anterior artery new smog blood vessels in 1 patient,and internal carotid artery steal blood in 1 patient.Conclusion Primary,secondary and tertiary collateral circulation can be started for different pathological conditions in patients with bilateral carotid stenosis/occlusive lesions.

关 键 词：颈动脉狭窄 侧支循环 卒中 动脉粥样硬化 

分 类 号：R743.3[医药卫生—神经病学与精神病学]