摘要
目的探讨支架成形术治疗颅内动脉狭窄导致出血并发症的常见原因及防治措施。方法回顾性分析2006年7月至2011年12月完成的366例颅内支架成形术的临床资料。有14例发生出血并发症，其中男12例、女2例，年龄36-76岁，平均（57±12）岁。以接受手术的前100例为界限分为前期手术组和后期手术组。分析导致出血的原因，探讨如何预防及处理出血并发症。结果本组颅内支架成形术出血并发症总发生率3．8％（14／366），前期手术组发生率10．0％（10／100）、后期手术组发生率1．5％（4／266）。其中6例出血并发症与手术操作相关，1例是微导丝置于远端分支动脉时刺破动脉、1例球囊扩张时导致血管破裂、1例将球囊于支架内再次扩张后发生出血、3例微导丝头端突然前蹿刺破了分支动脉；8例与过度灌注相关，其中3例为适应证掌握不严格所致；死亡6例，重残3例，轻瘫痪2例，3例无神经功能缺失。结论颅内支架成形术出血并发症具有较高的致残率和致死率，但术者可以在提高手术操作技巧、严格选择适应证的基础上，减少出血并发症的发生。
Objective To summarize the reasons of bleeding complications and the prevention methods in stenting for intracranial arterial stenosis. Methods The clinical data of 366 patients underwent stent-assistant angioplasty of intracranial artery stenosis from July 2006 to December 2011 were analyzed retrospectively. Among them, 14 patients with bleeding complications were found. The initial 100 patients were categorized as early stage group and the rest as mature stage group. The reasons of bleeding and the methods for preventing this complication were summarized. Results The overall incidence of bleeding complication was 3.8% （14/366）. In the early stage group and mature stage group, the rates was 10% （10/100） and 1.5% （4/266）. Six cases were related to the operational manipulation and 8 cases secondary to hyperperfusion injury. Death was found in 6 patients, severe disability in 3, mild paralysis in 2, and no neurological deficits in 3. Conclusions The bleeding complications in stent-assisted angioplasty of intracranial artery stenosis have a high disability and mortality. The improvement of operative techniques and the more strict indications decrease the bleeding complications rate effectively.
出处
《中华放射学杂志》
CAS
CSCD
北大核心
2012年第6期548-551,共4页
Chinese Journal of Radiology
基金
黑龙江省留学归国基金资助项目（LC201014）
关键词
大脑中动脉
基底动脉
支架
脑出血
Middle cerebral artery
Basilar artery
Stents
Cerebral hemorrhage
