Department of Neurosurgery, University at Buffalo, State University of New York, Buffalo, New York 14209, USA.
J Neurointerv Surg. 2011 Dec 1;3(4):369-74. doi: 10.1136/jnis.2011.004754. Epub 2011 Mar 15.
The authors report the endovascular treatment of intracranial stenosis in six patients with moyamoya-type collaterals.
All patients previously had experienced a stroke or transient ischemic attack. Lesion locations included a unilateral M1-segment lesion in five patients; and ipsilateral internal carotid artery (ICA)-T, M1 and A1 lesions with contralateral supraclinoid ICA stenosis in one patient. Mean M1 stenosis was 77.3 ± 14.3%.
Six patients had balloon angioplasty; in one, a Wingspan stent deployed successfully after angioplasty failed to relieve the stenosis. Mean post-treatment stenosis was 41.0 ± 33.0%. In one patient, vessel rupture occurring during angioplasty caused severe disability. Two patients were asymptomatic for 4 years and 6 months, respectively. One asymptomatic patient had severe restenosis re-treated with intracranial stenting. Two patients became symptomatic and had re-treatment at 1 and 2 months, respectively.
Endovascular treatment of intracranial stenosis with moyamoya-type collaterals is possible but is associated with high rates of symptomatic restenosis and target-lesion revascularization.
作者报告了 6 例烟雾病样侧支血管颅内狭窄的血管内治疗。
所有患者此前均经历过卒中或短暂性脑缺血发作。病变部位包括 5 例单侧 M1 段病变；1 例同侧颈内动脉（ICA）-T、M1 和 A1 病变伴对侧颅底 ICA 狭窄。平均 M1 狭窄率为 77.3%±14.3%。
6 例患者接受了球囊血管成形术；其中 1 例在血管成形术未能缓解狭窄后成功植入 Wingspan 支架。治疗后平均狭窄率为 41.0%±33.0%。1 例患者在血管成形术中发生血管破裂，导致严重残疾。2 例患者分别无症状 4 年 6 个月。1 例无症状患者因严重再狭窄而行颅内支架治疗。2 例患者分别在 1 个月和 2 个月后出现症状并再次治疗。
烟雾病样侧支血管颅内狭窄的血管内治疗是可行的，但与较高的症状性再狭窄和靶病变血管重建率相关。
