Liu Xintong, Wang Wei, Tang Zhouping, Zeng Wengao, He Chizhong, Wang Lijuan, Lu Haike, Li Changmao, Zhang Xiong, Wang Shuo, Dai Chengbo, Ma Guixian, Yang Zhexian, Ma Tengyun
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
Department of Neurology, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510100, China.
J Huazhong Univ Sci Technolog Med Sci. 2011 Feb;31(1):67-72. doi: 10.1007/s11596-011-0152-6. Epub 2011 Feb 19.
The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored. The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug. 2007 to Nov. 2009 were retrospectively analyzed. In total 132 stents were implanted in the 111 patients. The mortality and rate of neural and non-neural complications were assessed perioperatively. Outcomes [including the frequency of transient ischemic attack (TIA), stroke, or death from vascular diseases) were assessed after operation. NIHSS rating was performed in all cases before and at first week, 6th month and 12th month after the operation. The PTAS success rate was 100%. The degree of stenosis was reduced after PTAS. The total complication rate during perioperative period was 15.3% (the rate of neural complications was 3.6%). Sixty-seven patients were followed up. Three patients (4.48%) developed cerebrovascular events within 1 month, containing one case of TIA, one case of ipsilateral mild stroke and one case of contralateral mild stroke. No severe stroke or death was observed. During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44%), including 2 cases of ipsilateral TIA (2.99%), 2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99%), one case of severe stroke (1.49%). In 13 patients receiving DSA re-examination one year after PTAS, 2 patients (15.38%) had in-stent restenosis. NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P<0.05). It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease. The success rate of PTAS was high, and the rate of complications was lower and the clinical outcomes were satisfactory. PTAS is a safe and effective therapeutic method, though the long-term outcomes need further study.
探讨经皮腔内血管成形术及支架置入术（PTAS）治疗动脉狭窄所致缺血性脑血管病患者的疗效。回顾性分析2007年8月至2009年11月在广东省总医院接受PTAS治疗的111例缺血性脑血管病患者的临床资料。111例患者共植入132枚支架。围手术期评估死亡率及神经和非神经并发症发生率。术后评估结局[包括短暂性脑缺血发作（TIA）、卒中或血管疾病死亡的发生频率]。所有病例在术前及术后第1周、第6个月和第12个月进行美国国立卫生研究院卒中量表（NIHSS）评分。PTAS成功率为100%。PTAS后狭窄程度降低。围手术期总并发症发生率为15.3%（神经并发症发生率为3.6%）。对67例患者进行随访。3例患者（4.48%）在1个月内发生脑血管事件，包括1例TIA、1例同侧轻度卒中和1例对侧轻度卒中。未观察到严重卒中或死亡。在12个月的随访期内，7例患者发生脑血管事件（10.44%），包括2例同侧TIA（2.99%）、2例同侧轻度卒中和2例对侧轻度卒中（2.99%）、1例严重卒中（1.49%）。在PTAS术后1年接受DSA复查的13例患者中，2例患者（15.38%）发生支架内再狭窄。随访期间NIHSS评分较术前明显降低（P<0.05）。结论：PTAS可显著改善缺血性脑血管病患者的神经功能缺损。PTAS成功率高，并发症发生率低，临床疗效满意。PTAS是一种安全有效的治疗方法，尽管长期疗效有待进一步研究。
