Zhang Xiao-bo, Jin Zheng-yu, Yang Ning, Liu Wei, Pan Jie, Li Xiao-guang, Cui Li-ying, Wang Jian-ming, Gao Shan, Gao Jing
Department of Radiology, PUMC Hospital, CAMS and PUMC, Beijing 100730, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2006 Apr;28(2):214-8.
To evaluate the therapeutic effect of percutaneous transluminal angioplasty and stenting for occlusive lesions in supra-arch vessels with brain ischemic symptoms.
A total of 56 occlusive lesions of the innominate, subclavian, and internal carotid arteries were treated with angioplasty and intravascular stent placement in 52 patients. The degree of stenosis was more than 60% in all patients and the leading symptom was brain ischemia. In 11 patients, the occluded subclavian artery could not be crossed via the femoral route, therefore the brachial route was used and the occlusion was crossed in a retrograde fashion.
Technical success was achieved in 54 of 56 procedures (96.4%). Residual stenosis was less than 30% in all cases. The clinical symptoms improved after procedure in all patients. Complications occurred in 3 of 52 (5.8%) procedures, and the 30-day mortality rate was 0. There were no death and severe stroke in the follow-up period (means 24 months). Restenosis was observed in 2 patients after percutaneous transluminal angioplasty treatment.
Percutaneous transluminal angioplasty with or without stenting is a safe and valid choice for treatment of occlusive lesions of supra-arch vessels in patients with cerebral ischemic symptoms.
评估经皮腔内血管成形术及支架置入术治疗伴有脑缺血症状的弓上血管闭塞性病变的疗效。
52例患者共56处无名动脉、锁骨下动脉及颈内动脉闭塞性病变接受了血管成形术及血管内支架置入治疗。所有患者狭窄程度均超过60%，主要症状为脑缺血。11例患者经股动脉途径无法穿过闭塞的锁骨下动脉，因此采用肱动脉途径并逆行穿过闭塞段。
56例手术中有54例（96.4%）技术成功。所有病例残余狭窄均小于30%。所有患者术后临床症状均有改善。52例手术中有3例（5.8%）发生并发症，30天死亡率为0。随访期（平均24个月）内无死亡及严重卒中发生。2例患者经皮腔内血管成形术治疗后出现再狭窄。
对于伴有脑缺血症状的患者，经皮腔内血管成形术无论是否联合支架置入都是治疗弓上血管闭塞性病变的安全有效的选择。
