Marks M P, Marcellus M, Norbash A M, Steinberg G K, Tong D, Albers G W
Department of Radiology, Stanford Stroke Center, Stanford University Medical Center, California, 94305-5105, USA.
Stroke. 1999 May;30(5):1065-9. doi: 10.1161/01.str.30.5.1065.
We sought to assess the long-term outcome and efficacy of percutaneous transluminal angioplasty in the treatment of symptomatic intracranial atherosclerotic stenoses.
Twenty-three patients with fixed symptomatic intracranial stenoses were treated over a 5-year period with percutaneous transluminal angioplasty. Patients who underwent successful angioplasty were followed up for 16 to 74 months (mean, 35.4 months).
An angioplasty that resulted in decreased stenosis was performed in 21 of 23 patients (91.3%). In 1 case a stenosis could not be safely crossed, and in another balloon dilatation resulted in vessel rupture. This vessel rupture resulted in the 1 periprocedural death in the series. In follow-up there was 1 stroke in the same vascular territory as the angioplasty and 2 strokes in the series overall. This yielded an annual stroke rate of 3.2% for strokes in the territory appropriate to the site of angioplasty.
Intracranial angioplasty can be performed with a high degree of technical success. The long-term clinical follow-up available in this series suggests that it may reduce the risk of future stroke in patients with symptomatic intracranial stenoses.
我们旨在评估经皮腔内血管成形术治疗有症状颅内动脉粥样硬化狭窄的长期疗效。
在5年期间，对23例有症状的固定性颅内狭窄患者进行了经皮腔内血管成形术治疗。成功接受血管成形术的患者随访了16至74个月（平均35.4个月）。
23例患者中有21例（91.3%）进行了导致狭窄程度降低的血管成形术。1例患者狭窄处无法安全通过，另1例球囊扩张导致血管破裂。该血管破裂导致了本系列中的1例围手术期死亡。随访期间，在血管成形术同一血管区域发生1次卒中，本系列总体发生2次卒中。这使得适合血管成形术部位的区域年度卒中发生率为3.2%。
颅内血管成形术可取得较高的技术成功率。本系列现有的长期临床随访表明，它可能降低有症状颅内狭窄患者未来发生卒中的风险。
