摘要
目的总结应用药物洗脱支架治疗椎基底动脉狭窄的经验,探讨其近、中期疗效、安全性及预防再狭窄的作用。方法27例患者均为反复短暂性脑缺血发作(TIA)或脑梗死后恢复良好,狭窄程度在50%以上且常规药物治疗无效。在局麻或全麻下,采用直接支架成形术进行治疗。术后常规给予抗血小板聚集治疗,并定期进行临床和影像学随访。结果27例患者28处脑动脉狭窄采用药物洗脱支架进行治疗,其中27处成功植入药物洗脱支架(Cypher支架24枚,Taxus支架2枚,Firebird支架1枚)。平均狭窄程度从术前(74．5±6．7)%减少到(8．7±4．4)%。2例发生穿支血管闭塞症状。术后临床随访2～14个月,无一例患者出现TIA或卒中复发。14例患者接受血管造影随访,随访时间为3～18个月,1例支架近端狭窄(＜50%),无一例支架内再狭窄。结论短期结果显示应用药物洗脱支架治疗脑供血动脉狭窄是安全和有效的,但长期疗效有待于进一步观察。
Objective To evaluate the early results and mid-term outcomes following angioplasty of vertebro-basilar arterial stenosis with drug-eluting stents. Methods All of the patients presented with recurrent TIA or ceretral infarction with 〉 50% stenoses in vertebro-basilar arteries, and having failure in maximal medical therapy. All of the lesions were treated with primary stenting under local or general anesthesia and followed by continual anticoagulant therapy of clopidogrel and aspirin together with clinical follow-up and vascular imagings. Results Of 28 stenoses （27 patients）, 27 lesions were successfully treated with implantation of 24 Cypher stents, 2 Taxus stents and one Firebird stent. The mean stenotic severity reduced from （74 ± 6.7）% to （8.7 ± 4.4）%. Two patients had inchemic events relating to penetration vascular obstruction. During 2- 14 months follow-up, the patients were clinically asymptomatic with no recurrent TIA/ stoke. Angiographic follow-up was obtained in 14 patients at a mean of 7.2 months. Proximal restenosis（〈 50%） occurred in one patient（3.3%）, and corrected with restenting, while others were free of intra-stent restenoses. Conclusion Using DES in cerebrovascular stenosis is safe and effective with lowing the risk of intra-stent restenosis in comparison with bare stent. Further study for long term efficiency is still in need.
出处
《介入放射学杂志》
CSCD
2006年第11期643-647,共5页
Journal of Interventional Radiology
关键词
脑缺血
支架成形术
介入
Cerebral ischemia
Angioplasy
Intervention
