改良椎动脉-颈总动脉转位术治疗椎动脉V1段狭窄  

Modified vertebral-carotid transposition treating stenosis at V1 segment of vertebral artery

作　　者：顾沅芮 孙阳雪 覃一朗 田晨[1] 任晶晶 田川[1] 方坤[1] 欧阳文斌[1] 张瑛[1] 罗明尧[1] 舒畅[1] 欧阳晨曦[1] GU Yuanrui;SUN Yangxue;QIN Yilang;TIAN Chen;REN Jingjing;TIAN Chuan;FANG Kun;OUYANG Wenbin;ZHANG Ying;LUO Mingyao;SHU Chang;OUYANG Chenxi(Department of Vascular Surgery,Fuwai Hospital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China;Party and Government Office,Fuwai Hospital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,100037,P.R.China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院血管外科,北京100037 [2]中国医学科学院北京协和医学院国家心血管病中心阜外医院党政办公室,北京100037

出　　处：《中国胸心血管外科临床杂志》2022年第3期366-370,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家重点研发计划项目(2018YFC1105501);北京市科技计划项目(Z191100007619039)。

摘　　要：目的探索改良椎动脉-颈总动脉转位术(vertebral-carotid transposition,VCT)在椎动脉V1段重度狭窄至闭塞患者中的治疗。方法回顾性分析2016年10月—2018年12月阜外医院采用改良VCT治疗的13例椎动脉V1段重度狭窄至闭塞患者的临床资料,其中男10例、女3例,平均年龄(70.5±7.1)岁。结果 13例患者手术均成功,随访时间为1~3年,术后患侧椎动脉V1段的狭窄程度由86.8%±7.5%下降至17.4%±14.5%。所有患者术后症状均改善,6例患者出现暂时性周围神经损伤症状,术后随访发现其中4例患者周围神经损伤症状消失,1年和3年通畅率均为100.0%,未出现围手术期死亡、卒中、术后再次治疗等。结论改良VCT能确切地恢复椎动脉V1重度狭窄至闭塞患者的远端血流,改善其症状。Objective To investigate the treatment of modified vertebral-carotid transposition(VCT) in patients with severe stenosis or occlusion at V1 segment of vertebral artery. Methods A retrospective study of 13 patients with severe stenosis or occlusion at V1 segment of vertebral artery treated by modified VCT in our hospital from October 2016 to December 2018 was done. There were 10 males and 3 females with an average age of 70.5±7.1 years. Results The operation was successful in this series of patients. The follow-up duration was 1-3 years. The stenosis degree of the V1 segment of the vertebral artery decreased from 86.8%±7.5% to 17.4%±14.5%. All patients achieved remission of symptoms after the surgery. Temporary peripheral nerve injury occurred in 6 patients. Four patients with neurological complications relieved during follow-up. The patency rate was 100.0% at postoperative 1 and 3 years. There was no perioperative death,stroke or re-intervention. Conclusion Modified VCT can precisely restore the distal blood flow of patients with severe stenosis or occlusion at V1 segment of vertebral artery, and relieve their symptoms.

关 键 词：椎动脉-颈总动脉转位术 椎动脉闭塞 椎动脉重度狭窄 

分 类 号：R651.1[医药卫生—外科学]