[有症状的椎基底动脉供血不足老年患者的管理]

[Management of elderly patients with symptomatic vertebrobasilar insufficiency].

作者信息

Lu Jun, Wang Da-Ming, Chen Hai-Bo, Liu Jia-Chun, Liu Fang, Jiang Hong-Zhi, Li Jin, Wang Li-Jun, Gong Tao, Jiang Xue-Li, Zhai Le-Le

机构信息

Department of Neurosurgery, Beijing Hospital, Beijing 100730, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2007 Feb 15;45(4):226-9.

PMID:17502013

Abstract

OBJECTIVE

To evaluate the feasibility, safety and short-term efficacy of stent-assisted angioplasty and/or drug therapy for elderly patients with symptomatic vertebrobasilar insufficiency.

METHODS

Elderly patients (> or = 60 years old) with symptomatic vertebrobasilar stenosis (> or = 50%) demonstrated by cerebral angiography were treated with drug therapy and some with endovascular stenting further from April 2001 to June 2006. The clinical, imaging, intervention and follow-up data were collected and analyzed.

RESULTS

Eighty-one elderly patients were chosen for study, including 68 males and 13 females. The mean age is 70 years (60 - 87 years); stroke rate of 4.9% (4/81) and stroke-related mortality rate of 2.5% (2/81) were found in this group during hospitalization and follow-up (mean 28.1 months), and symptoms resolved or improved clinically in 66 (81.5%). Fifty-two balloon expandable stents were placed in 48 (59.3%) patients of this group with a technical success rate of 98.1% and the mean degree of stenosis was reduced from (82.4 +/- 13.1)% to (6.4 +/- 3.2)% (t = 22.4, P = 0.00).

CONCLUSIONS

Appropriate management including endovascular stenting and/or drug therapy may improve short-term outcomes of elderly patients with symptomatic vertebrobasilar insufficiency; meanwhile, stent-assisted angioplasty is technically feasible and relatively safe.

摘要

目的

评估支架辅助血管成形术和/或药物治疗对有症状的老年椎基底动脉供血不足患者的可行性、安全性及短期疗效。

方法

选取2001年4月至2006年6月期间经脑血管造影证实有症状的椎基底动脉狭窄（≥50%）的老年患者（≥60岁），先给予药物治疗，部分患者进一步行血管内支架置入术。收集并分析临床、影像学、干预及随访数据。

结果

选取81例老年患者进行研究，其中男性68例，女性13例。平均年龄70岁（60 - 87岁）；该组患者在住院及随访期间（平均28.1个月）的卒中发生率为4.9%（4/81），卒中相关死亡率为2.5%（2/81），66例（81.5%）患者的症状在临床上得到缓解或改善。该组48例（59.3%）患者置入了52枚球囊扩张支架，技术成功率为98.1%，平均狭窄程度从（82.4±13.1）%降至（6.4±3.2）%（t = 22.4，P = 0.00）。