Zhang Quan-zhong, Miao Zhong-rong, Li Shen-mao, Zhu Feng-shui, Hua Yang, Wang Mo-li, Song Qing-bin, Ling Feng
Department of Neurosurgery, Xuanwu hospital, Thecapital medical university, Beijing 100053, China.
Zhonghua Yi Xue Za Zhi. 2003 Aug 25;83(16):1402-5.
To discuss the safety of intracranial stenting for refractory symptomatic intracranial artery stenosis.
Forty-eight patients with symptomatic intracranial artery stenosis were treated by transluminal stent-assistant angioplasty. Of them, 40 cases were selected because they had recurrent TIAs or mild stroke despite of antiplatelet or anticoagulation therapy; 8 cases with high-grade stenosis after acute cerebral artery theromblysis. Lesions involved MCA (17/48); Basilar artery (8/48); intracranial vertebral artery (18/18); and distal ICA (5/18).
For 46 of 48 cases the flexible coronary stent were successfully deployed. The average stenosis reduced from 83% to 5%, short-term follow-up showed good clinical improvement. Complications include vessel rupture (1/18); acute thrombosis within stent (1/48); perforation of cortical artery (1/18) and perforate vessel occlusion (1/18).
Stent-assistant angioplasty are effective for treatment of symptomatic intracranial stenosis, the higher rate of complications may be because of the limited experiences of this technique. it need further practise and long term follow-up study.
探讨颅内支架置入术治疗症状性颅内动脉狭窄的安全性。
48例症状性颅内动脉狭窄患者接受经皮腔内支架辅助血管成形术治疗。其中,40例患者尽管接受了抗血小板或抗凝治疗仍有复发性短暂性脑缺血发作(TIA)或轻度卒中;8例患者在急性脑动脉溶栓后出现重度狭窄。病变累及大脑中动脉(17/48);基底动脉(8/48);颅内椎动脉(18/48);以及颈内动脉远端(5/48)。
48例患者中有46例成功植入了可弯曲冠状动脉支架。平均狭窄率从83%降至5%,短期随访显示临床症状有明显改善。并发症包括血管破裂(1/48);支架内急性血栓形成(1/48);皮质动脉穿孔(1/48)和穿支血管闭塞(1/48)。
支架辅助血管成形术治疗症状性颅内狭窄有效,并发症发生率较高可能是由于该技术经验有限。需要进一步实践和长期随访研究。