Weber Werner, Mayer Thomas E, Henkes Hans, Kis Bernhard, Hamann Gerhard F, Schulte-Altedorneburg Gernot, Brueckmann Hartmut, Kuehne Dietmar
Department of Radiology and Neuroradiology, Alfried Krupp Hospital Essen, Alfried Krupp Str. 21, D-45117 Essen, Germany.
Eur J Radiol. 2005 Aug;55(2):231-6. doi: 10.1016/j.ejrad.2004.11.010. Epub 2004 Dec 30.
To present our two-center treatment results with stent angioplasty of intracranial vertebrobasilar stenoses in symptomatic patients.
Between 2001 and 2003, 21 patients with 22 stenoses, refractory to medical therapy, who underwent elective stenting of intracranial vertebrobasilar stenoses were retrospectively analyzed. All patients had ischemic events clinically referable to the stenoses. Only high-grade stenoses of at least 80% were treated. Clinical evaluation was done based on the modified ranking scale (MRS).
In all cases, the stent deployment turned out to be technically successful and control angiography demonstrated the elimination of the high-grade stenoses. A minor residual stenoses was still detectable in six cases. According to the MRS, clinical outcome improved in the case of four patients, seemed unchanged in 14 and worsened in three. The clinical morbidity rate amounted to 14%. Clinical follow-up was available for 13 patients after 9 months with no recurrent symptoms and angiographic follow-up was available after 10 months. Re-stenoses occurred in two cases without clinical symptoms. Retreatment was not done.
According to our data, stent angioplasty for symptomatic intracranial vertebrobasilar stenoses can be a treatment alternative in case of recurrent symptoms despite medical therapy; particularly, for stenoses of type Mori A or B.
介绍我们对有症状患者进行颅内椎基底动脉狭窄支架血管成形术的两中心治疗结果。
回顾性分析2001年至2003年间21例患有22处狭窄、药物治疗无效且接受颅内椎基底动脉狭窄择期支架置入术的患者。所有患者临床上均有与狭窄相关的缺血事件。仅治疗至少80%的高度狭窄。基于改良Rankin量表（MRS）进行临床评估。
所有病例中，支架置入在技术上均获成功，控制血管造影显示高度狭窄已消除。6例仍可检测到轻微残余狭窄。根据MRS，4例患者临床结果改善，14例似乎未变，3例恶化。临床发病率为14%。9个月后13例患者有临床随访且无复发症状，10个月后有血管造影随访。2例出现再狭窄但无临床症状。未进行再次治疗。
根据我们的数据，对于有症状的颅内椎基底动脉狭窄，尽管进行了药物治疗但仍有复发症状时，支架血管成形术可作为一种治疗选择；特别是对于Mori A或B型狭窄。
