摘要
目的回顾性分析应用wingspan支架对症状性颅内椎基底动脉狭窄的治疗情况,评价其安全性及有效性。方法应用wingspan支架治疗症状性颅内椎基底动脉狭窄患者28例,观察其技术成功率、狭窄率的改变、围手术期并发症及术后症状改善情况。结果(1)28例患者共置入29枚wingspan支架,技术成功率100%。(2)术后即刻血管造影证实,狭窄率由(77.4±8.2)%降为(21.4±7.9)%。(3)2例(7.1%)患者出现围手术期并发症,考虑为穿支动脉闭塞。(4)28例患者术后随访6～21个月,按照malek评分,分别评价术后当时(24h内),术后1个月及最近时间预后情况,术后当时malek评分:1分26例(92.9%),4分2例(7.1%);1个月后评分:1分25例(89.3%),4分2例(7.1%),5分1例(3.6%)(术后2周死于肺部感染导致的呼吸衰竭)。最近随访术后6个月到21个月,平均(12.7±3.4)个月:1分24例(85.7%),3分1例(3.6%),5分2例(7.1%)(另一患者术后7个月死于脑出血),失访1例(3.6%)。结论应用wingspan支架治疗症状性颅内椎基底动脉具有较好的安全性及短期疗效,其长期疗效还需进一步随访。
Objective To retrospectively analyze the treatment of symptomatic intracranial vertebrobasilar stenosis with Wingspan stent and to evaluate the feasibility and safety. Methods 28 patients with symptomatic intracranial vertebrobasilar stenosis were treated by Wingspan stent-assisted angioplasty. Technical success rate,the degree of stenosis, periprocedural neurological complications and efficiency were observed. Results （ 1 ）28 patients were implanted 29 Wingspan stents. The technical success rate was 100%. （2）The mean degree of stenosis decreased from （77.4＋8.2）% before the procedure to （21.4＋7.9）% after stenting.（3 ）2 patients（7.1%） occurred periprocedural neurological complications caused by perforator strokes. （4）Follow-up （range,6-21months） was available for 28 patients. According to Malek scale, Neurological outcome was determined immediately after the procedure, at 30 days, and at latest follow-up. 26 patients （92.9%） belonged to scale 1, 2patients （7.1%）belonged to scale 4 after the procedure. At 30 days, 25patients （89.3%） belong to scale 1,2patients （7.1%）belonged to scale 4 and 1 patient （3.6%） belonged to scale 5 （died because of respiratory failure caused by pulmonary infection two weeks after procedure）. At latest follow-up （range, 6-21months,mean, 12.7±3.4 months）, 24 patients（ 85.7% ） belonged to scale 1, 1 patient（3.6%） belonged to scale 3, 2 patients（7.1% ） belonged to scale 5（the second patient died because of cerebral hemorrhage 7 months after procedure）, 1 patient（3.6% ）lost follow-up. Conclusion Wingspan stent for treatment of symptomatic intracranial vertebrobasilar stenosis is safe and feasible in short-term. However, long-term efficacy needs further investigation.
出处
《中国城乡企业卫生》
2013年第2期16-21,共6页
Chinese Journal of Urban and Rural Enterprise Hygiene
