Harakuni T, Hyodo A, Shingaki T, Kugai M, Kinjyo T, Kinjyo T, Tsuchida H, Sugimoto K, Yoshii Y, Matsumaru Y
Department of Neurosurgery, University of the Ryukyus, Okinawa; Japan.
Interv Neuroradiol. 2004 Mar 30;10 Suppl 1(Suppl 1):97-100. doi: 10.1177/15910199040100S115. Epub 2008 Jun 9.
Since May 1992, we have performed percutaneous transluminal angioplasty (PTA) or stenting 70 times for 65 lesions in 62 patients with atherosclerotic stenosis of the intracranial or skull base cerebral arteries. Stenting was carried out nine times for nine lesions in nine cases. Stenting was performed on patients with an average age of 62. The patients were eight men and one woman. The stenotic lesions involved the internal carotid artery (petrous portion) in four cases, the internal carotid artery (cavernous portion) in two cases, the internal carotid artery (supraclinoid portion) in one case, the middle cerebral artery (M1) in one case, and the vertebral artery (V4) in one case. The degree of stenosis ranged from 70% to 99%, with a mean of 80%. A stent for coronary arteries was used in all cases. After PTA was carried out in four cases, their initial extension was inadequate, and dissection was performed in five cases after PTA. As for the results of the treatment, subarachnoid haemorrhage occurred in one case due to perforation by the guidewire, and a major deficit was accepted. During the operation, asymptomatic cerebral infarction by distal embolism occurred in one case. Although obstruction of the lesion occurred three months after treatment in one case, symptoms did not appear. Stents used for atherosclerotic stenosis of the intracranial or skull base cerebral arteries still do not have sufficient performance. Although the stenting had problems, such as a prolonged patent, in the present condition, it was effective in terms of recovery from complications due to PTA.
自1992年5月以来，我们对62例颅内或颅底脑动脉粥样硬化狭窄患者的65处病变进行了70次经皮腔内血管成形术（PTA）或支架置入术。其中9例患者的9处病变进行了9次支架置入术。接受支架置入术患者的平均年龄为62岁，8例男性，1例女性。狭窄病变累及岩骨段颈内动脉4例、海绵窦段颈内动脉2例、床突上段颈内动脉1例、大脑中动脉M1段1例、椎动脉V4段1例。狭窄程度为70%至99%，平均为80%。所有病例均使用冠状动脉支架。4例患者进行PTA后初始扩张不足，5例患者在PTA后发生夹层。治疗结果方面，1例患者因导丝穿孔发生蛛网膜下腔出血，接受了严重神经功能缺损。手术过程中，1例患者因远端栓塞发生无症状性脑梗死。1例患者在治疗3个月后病变发生闭塞，但未出现症状。用于颅内或颅底脑动脉粥样硬化狭窄的支架性能仍不足。尽管支架置入存在诸如通畅时间延长等问题，但在目前情况下，它在PTA并发症的恢复方面是有效的。
