开放手术重建椎动脉V3段的单中心临床分析  

Clinical analysis of surgical reconstruction of the V3 segment of vertebral artery:A single-center experience

作　　者：杨根欢 廖鹏志 刘新农 汪岩[1] 沈晨阳 贾玉龙[1] Yang Genhuan;Liao Pengzhi;Liu Xinnong;Wang Yan;Shen Chenyang;Jia Yulong(Department of Vascular Surgery,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院血管外科,北京100070

出　　处：《中国血管外科杂志（电子版）》2024年第1期60-63,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的探讨开放手术重建椎动脉V3段的临床疗效并总结单中心治疗经验。方法收集首都医科大学附属北京天坛医院2019年3月至2023年7月4例应用开放手术重建椎动脉V3段的患者临床资料,回顾性分析椎动脉V3段重建的手术指征、重建策略、临床疗效及安全性。结果手术均取得成功。手术时间210~270 min,中位手术时间255 min;术中出血80~150 ml,中位出血量90 ml;椎动脉阻断时间15~20 min,中位阻断时间15 min。围手术期均无脑梗死、脑出血及高灌注综合征的发生。患者均获得随访,随访时间6~58个月,中位随访时间22.5个月,桥血管及吻合口均通畅,无新发脑梗死、脑出血及颅内缺血表现。结论开放手术重建椎动脉V3段安全有效,需根据患者弓上动脉病变情况采取个体化重建策略。Objective To evaluate the effect of surgical reconstruction of the V3 segment of vertebral artery and to summarize the single-center experience.Methods The clinical data of 4 patients undergoing surgical reconstruction of the V3 segment of vertebral artery from March 2019 to July 2023 at Beijing Tiantan Hospital,Capital Medical University were collected.Surgical indications,surgical method selection,effectiveness and safety were analyzed retrospectively.Results All patients underwent surgery successfully.The operation time was 210 to 270 min,with the median time of 255 min.The blood loss was 80 to 150 ml,with the median loss of 90 ml.The blocking time of vertebral artery was 15 to 20 min,with the media time of 15 min.There was no cerebral infarction,cerebral hemorrhage or cerebral hypoperfusion syndrome during the perioperative period.All patients were followed up for 6 to 58 months,with the median time of 22.5 months.There were no anastomotic stenosis,new cerebral infarction,cerebral hemorrhage or cerebral ischemia during the follow-up period.Conclusion Surgical reconstruction of the V3 segment of vertebral artery is safe and effective.Individualized reconstruction strategy should be adopted according to lesions of arteries above the aortic arch.

关 键 词：椎动脉 动脉狭窄 动脉闭塞 开放手术 血管重建 

分 类 号：R651.12[医药卫生—外科学]