Staikov I N, Do D D, Remonda L, Mattle H, Baumgartner R, Schroth G
Department of Neuroradiology, University Hospital of Bern, Inselspital, Switzerland.
Neuroradiology. 1999 Jul;41(7):537-42. doi: 10.1007/s002340050800.
We analysed the site of plaques and stenoses in the subclavian and vertebral arteries, to improve the safety of percutaneous transluminal angioplasty (PTA) in high-risk patients. These lesions were assessed on arteriograms of 35 patients with stenoses and occlusions of the subclavian and vertebral arteries; the degree of stenoses was measured. Of 19 subclavian artery stenoses 17 (89%) were in the segment proximal to the vertebral artery; 30 (79%) of 38 vertebral artery stenoses were on the medial wall. With this knowledge, a double-balloon technique using a simultaneous transbrachial and transfemoral approach for angioplasty of high-risk subclavian or combined subclavian and vertebral artery stenoses and occlusions was used successfully in seven patients. This new technique may broaden the endovascular therapeutic possibilities in the rare but dangerous situation where plaque extends directly from the stenotic subclavian artery into the origin of the vertebral artery.
我们分析了锁骨下动脉和椎动脉斑块及狭窄的部位，以提高高危患者经皮腔内血管成形术（PTA）的安全性。对35例锁骨下动脉和椎动脉狭窄及闭塞患者的动脉造影片上的这些病变进行了评估；测量了狭窄程度。在19处锁骨下动脉狭窄中，17处（89%）位于椎动脉近端；38处椎动脉狭窄中有30处（79%）位于内侧壁。基于这一认识，一种双球囊技术成功应用于7例高危锁骨下动脉或合并锁骨下动脉和椎动脉狭窄及闭塞患者的血管成形术，该技术采用经肱动脉和股动脉同时入路。在斑块直接从狭窄的锁骨下动脉延伸至椎动脉起始部这种罕见但危险的情况下，这项新技术可能会拓宽血管内治疗的可能性。
