Gateway球囊扩张治疗症状性大脑中动脉重度狭窄患者效果评价  

Evaluation of the efficacy of Gateway balloon dilatation for symptomatic severe stenosis of middle cerebral artery

作　　者：周兴磊 魏锋 吴胤菲 雷剑伟 宋思辉 宋书欣[1] ZHOU Xinglei;WEI Feng;Wu Yinfei;LEI Jianwei;SONG Sihui;SONG Shuxin(Department of Neurosurgery,Second Affiliated Hospital of Nanchang University,Nanchang,Jiangxi Province 330006,China)

机构地区：[1]南昌大学第二附属医院神经外科,江西南昌330006

出　　处：《介入放射学杂志》2024年第10期1106-1110,共5页Journal of Interventional Radiology

基　　金：江西省卫生健康委科技计划项目(202210588)。

摘　　要：目的评价Gateway球囊扩张术治疗症状性大脑中动脉重度狭窄的效果。方法回顾性分析2019年5月至2022年8月南昌大学第二附属医院收治的98例症状性大脑中动脉重度狭窄患者临床及影像学资料。分析Gateway球囊扩张治疗前后狭窄血管直径,狭窄段收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV),狭窄病变Mori分型,手术并发症,影像学及临床随访结果等。结果98例患者中Mori分型A型83例(84.69%),B型15例(15.31%)。所有患者Gateway球囊扩张治疗均获成功。术后症状均有不同程度改善或稳定。狭窄病变残余管腔直径由术前(2.01±0.13)mm显著增大至术后(2.33±0.25)mm,狭窄程度由术前(81.28±15.17)%显著降低至术后(50.24±12.83)%,PSV、EDV分别由术前(251.01±60.13)cm/s、(104.28±32.25)cm/s显著降低至术后(155.33±53.28)cm/s、(70.24±36.33)cm/s,差异有统计学意义(均P<0.05)。7例患者出现手术并发症,症状随后得到改善。临床随访10个月,88例(89.79%)患者改良Rankin量表(mRS)评分≤2分,显示生活质量和功能恢复良好。结论Gateway球囊扩张治疗症状性大脑中动脉重度狭窄远期疗效显著,手术并发症少,是治疗该类疾病的有效手段。Objective To evaluate the efficacy of Gateway balloon dilation in the treatment of symptomatic severe stenosis of middle cerebral artery.Methods The clinical data and imaging materials of 98 patients with severe symptomatic stenosis of the middle cerebral artery,who were admitted to the Second Affiliated Hospital of Nanchang University of China from May 2019 to August 2022 to receive Gateway balloon dilation,were retrospectively analyzed.The diameter of the narrowed artery before and after Gateway balloon dilation treatment,peak systolic blood flow velocity(PSV),end-diastolic blood flow velocity(EDV),Mori classification of stenosis lesion,operation-related complications,imaging manifestations and clinical follow-up results were analyzed.Results Of the 98 patients,Mori type A was seen in 83(84.69%)and Mori type B in 15(15.31%).Successful Gateway balloon dilation procedure was accomplished in all patients.After surgery,the symptoms were improved or stabilized to varying degrees.The mean residual lumen diameter of the stenosis lesion was significantly increased from preoperative(2.01±0.13)mm to postoperative(2.33±0.25)mm,the stenosis ratio was remarkably decreased from preoperative(81.28±15.17)%to postoperative(50.24±12.83)%,the PSV and EDV were strikingly decreased from preoperative(251.01±60.13)cm/s and(104.28±32.25)cm/s to postoperative(155.33±53.28)cm/s and(70.24±36.33)cm/s respectively,the differences were statistically significant(all P<0.05).Seven patients developed surgical complications,which were improved in short time.The patients were followed up for 10 months,modified Rankin Scale(mRS)score of≤2 points was obtained in 88 patients(89.79%),indicating that the patients had a good quality of life as well as a good functional recovery.Conclusion For the treatment of symptomatic severe stenosis of middle cerebral artery,Gateway balloon dilation carries a significant long-term therapeutic effect with fewer surgical complications.Therefore,Gateway balloon dilation is an effective treatment for this ty

关 键 词：Gateway球囊扩张 大脑中动脉重度狭窄 狭窄分型 狭窄程度 

分 类 号：R608[医药卫生—外科学]