摘要
目的探讨全脑血管造影对椎-基底动脉供血不足(VBI)的诊断作用及支架治疗效果。方法对182例临床诊断为椎-基底动脉供血不足的患者行数字减影血管造影(DSA)检查,并对其中48例适合介入治疗的VBI患者实施脑血管成形及支架治疗(CAS)。结果131例VBI患者存在不同类型的椎-基底动脉病变,包括动脉粥样硬化斑块形成所致狭窄76例、椎动脉起始部扭曲34例、颈椎横突孔骨性狭窄所致椎动脉狭窄2例、先天性椎动脉发育不良18例。动脉粥样硬化斑块所致病变中,包括锁骨下动脉狭窄9例、基底动脉狭窄8例、椎动脉起始部狭窄59例、锁骨下动脉完全闭塞4例。在DSA诊断基础上对适合血管内治疗的48例患者实施了CAS治疗,手术成功率为100%,术后6～12个月随访,48例患者均未见椎-基底动脉系统短暂性脑缺血发作(TIA)及新发后循环供血系统脑梗死。结论DSA对VBI患者的病因诊断有重要的临床指导意义,因为椎-基底动脉狭窄所致的VBI行血管成形及支架治疗可能是今后治疗本病的方法之一。
Objective To investigate the diagnosis of digital subtraction angiography and the effect of cerebral angio- plasty for vertebro-basilar insufficiecy.Methods Patients with VBI underwent clinical examination,digital subtraction an- giograghy(DSA)and neurologic examination before cerebral angioplasty and stenting(CAS)operation and after stent place- ment.Results Total of 182 patients were evaluated,and DSA showed that 131 VBI patients have vertebrobasilar atery diseases, including arteriosclerosis stenosis,twisting of the VA origin,VA stenosis in cervical transverse foramen,VA hypoplasia,arteri- osclerosis stenosis of the subclavian artery,basilar artery,VA origin stenosis,subclavian artery occlusion.Forty-eight patients with VBI underwent CAS with all procedures being successful.No CAS patients developed TIA and stroke with 6～12 months of follow-up.Conclusion CAS can be effectively performed in patients with VBI due to an artery stenosis.With proper selection of the patients and correct technique application,CAS could be safe and effective in stroke prevention and treatment.
出处
《中国卒中杂志》
2006年第1期15-17,共3页
Chinese Journal of Stroke
作者简介
帅杰,通讯作者:帅杰,400037 重庆市,第三军医大学新桥医院神经内科;E-mail:neurosj@hotmail.com
