症状性颅内椎基底动脉狭窄的治疗进展  

Advances in the treatment of symptomatic intracranial vertebrobasilar stenosis

作　　者：张巧玉 刘嘉慧 徐琳颖 季晓飞[1] ZHANG Qiaoyu;LIU Jiahui;XU Linying;JI Xiaofei(First Afiliated Hospital of Dalian Medical University,Dalian,Liaonin Province 116011,China)

机构地区：[1]大连医科大学附属第一医院,辽宁大连116011

出　　处：《介入放射学杂志》2023年第9期924-930,共7页Journal of Interventional Radiology

摘　　要：颅内椎基底动脉狭窄是后循环缺血性卒中的主要病因,与前循环血管相比,其走形更为迂曲、狭窄部位血管解剖结构更为复杂,其所致卒中复发率及致死、致残率更高,治疗更具挑战性,但在临床上却很少被关注,最佳的临床决策尚不明确。其主要的治疗方式包括危险因素管理、降脂治疗、抗血小板药物治疗、血管内治疗、手术治疗以及其他治疗等。本文对上述治疗方式作一综述,旨在为症状性颅内椎基底动脉狭窄患者的临床治疗和脑卒中二级预防提供参考。Clinically,intracranial vertebrobasilar stenosis(IVBS)is the main cause of posterior circulation ischemic stroke.Compared with the vessels of the anterior circulation,the vessels of IVBS are more tortuous,and the vascular anatomy of the stenosis is more complex.The recurrence rate of stroke,the mortality and the disability rate of IVBS are higher,so its treatment is more challenging.Unfortunately,IVBS has received very lttle clinical attention,and there is no generally accepted specific therapeutic regimen so far in clinical practice.At present,the main treatment methods for IVBS include risk factor management,lipid-lowering therapy,antiplatelet drug therapy,endovascular therapy,surgical treatment,etc.This paper aims to make a comprehensive review about the above treatment methods so as to provide practical references for the treatment of patients with symptomatic IVBS as well as for the secondary prevention of stroke.

关 键 词：症状性颅内椎基底动脉狭窄 药物治疗 经皮球囊血管成形术 经皮支架植入术 血管内治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]