Kizilkiliç Osman, Oğuzkurt Levent, Yildirim Tülin, Tercan Fahri, Karakurum Başak, Karaca Sibel, Giray Semih, Arlier Zülfikar
Başkent Universitesi Adana Uygulama ve Araştirma Hastanesi, Radyoloji Kliniği, Adana, Turkey.
Tani Girisim Radyol. 2004 Sep;10(3):252-8.
Atherosclerotic stenosis of the vertebrobasilar system most commonly occurs at the vertebral artery origin. Stenting of these stenotic lesions in combination with antithrombotics with or without anticoagulants is a safe and effective treatment method. The purpose of this study is to present the results of vertebral artery origin stenting in 14 high-risk patients.
Significant vertebral artery origin stenosis was treated with primary stenting in 14 patients, aged between 58 and 74 years (mean, 66+/-5.3 years). Eleven patients were male, and three were female. Vertebral artery stenosis was detected in eight patients prior to coronary artery surgery, and in six patients after a posterior system stroke or during evaluation of a vertebrobasilar insufficiency. All stenosis were successfully treated with stent placement. Except one patient who had a left posterior cerebral artery infarction, all patients had an uneventful procedure without any complication. Third-month and sixth-month clinical and color Doppler follow-up examinations were available in ten patients, and 12th-month control angiography performed in three patients did not show stent restenosis. None of the patients had new neurologic deficit during the follow-up.
Vertebral artery origin stenoses are one of the most common causes of vertebrobasilar stroke. In the presence of concomitant cerebral artery stenosis or systemic disorders, patients are under high risk even if they are on medical therapy. Primary stenting combined with medical treatment is a safe and effective treatment modality.
椎基底动脉系统的动脉粥样硬化狭窄最常发生在椎动脉起始部。对这些狭窄病变进行支架置入术并联合使用抗血栓药物（有或无抗凝药物）是一种安全有效的治疗方法。本研究的目的是展示14例高危患者椎动脉起始部支架置入术的结果。
14例年龄在58至74岁（平均66±5.3岁）的患者因严重的椎动脉起始部狭窄接受了初次支架置入术。其中11例为男性，3例为女性。8例患者在冠状动脉手术前被检测出椎动脉狭窄，6例患者在发生后循环卒中后或在评估椎基底动脉供血不足期间被检测出椎动脉狭窄。所有狭窄均通过支架置入成功治疗。除1例发生左大脑后动脉梗死的患者外，所有患者手术过程均顺利，无任何并发症。10例患者进行了第3个月和第6个月的临床及彩色多普勒随访检查，3例患者进行的第12个月对照血管造影未显示支架再狭窄。随访期间所有患者均未出现新的神经功能缺损。
椎动脉起始部狭窄是椎基底动脉卒中最常见的原因之一。在合并脑动脉狭窄或全身性疾病的情况下，即使患者接受药物治疗，其风险也很高。初次支架置入术联合药物治疗是一种安全有效的治疗方式。
