Cai Xueli, Wei Yixin, Ren Shaojun, Wu Zhiping, Peng Xiao, Huang Yuejin, Huang Liangtong, Liu Xiumei, Yang Zhihua
Department of Neurology, Lishui Hospital of Zhejiang University (the Central Hospital of Lishui), Zhejiang, China.
Department of Orthopaedics, Lishui Hospital of Zhejiang University (the Central Hospital of Lishui), Zhejiang, China.
Wideochir Inne Tech Maloinwazyjne. 2018 Jun;13(2):227-232. doi: 10.5114/wiitm.2018.73435. Epub 2018 Feb 12.
Vertebral artery stenosis is a major cause of posterior circulation ischemia in the elderly. There is not a clear consensus on the optimal therapeutic approach for symptomatic extracranial vertebral artery stenosis.
To evaluate the feasibility and efficacy of balloon-expandable stent angioplasty in the treatment of vertebral artery stenosis in the V2 segment.
Five patients with vertebral artery stenosis (V2 segment) and treatment of percutaneous transluminal stenting from July 2009 to June 2014 were retrospectively evaluated. All patients underwent color Doppler, transcranial color Doppler (TCD), CT angiography (CTA) and cerebral digital subtraction angiography (DSA) preoperatively. Whether there was osseous oppression was determined according to neck computed tomography (CT) and CTA. After the surgery, angiography was performed to determine if there was infarction or bleeding in the intracranial vertebral artery, basilar artery and posterior cerebral artery. The surgical parameters, residual stenosis, complications, etc. were recorded and evaluated. The patients were followed up accordingly.
Five patients (3 males, 2 females; average age of 66 ±4.2, range of 54-75) were enrolled in the study. Balloon-expandable stents were successfully implanted in the 5 patients. The mean residual stenosis after the balloon-expandable stenting (preoperative: average, 87.0 ±6.6%, range: 75-93%) was 12.6 ±7.8% (range: 5-25%). The clinical symptoms disappeared or receded. No serious complications occurred.
The balloon-expandable stent angioplasty seemed to be feasible and efficacious in treating vertebral artery stenosis in the V2 segment. Further study with a large sample size is needed.
椎动脉狭窄是老年人后循环缺血的主要原因。对于有症状的颅外椎动脉狭窄的最佳治疗方法，目前尚无明确共识。
评估球囊扩张支架血管成形术治疗椎动脉V2段狭窄的可行性和疗效。
回顾性评估2009年7月至2014年6月期间5例接受经皮腔内血管成形术治疗的椎动脉（V2段）狭窄患者。所有患者术前均接受彩色多普勒、经颅彩色多普勒（TCD）、CT血管造影（CTA）和脑数字减影血管造影（DSA）检查。根据颈部计算机断层扫描（CT）和CTA确定是否存在骨性压迫。术后进行血管造影，以确定颅内椎动脉、基底动脉和大脑后动脉是否有梗死或出血。记录并评估手术参数、残余狭窄、并发症等情况。并对患者进行相应随访。
5例患者（男性3例，女性2例；平均年龄66±4.2岁，范围54 - 75岁）纳入本研究。5例患者均成功植入球囊扩张支架。球囊扩张支架置入术后的平均残余狭窄率（术前：平均87.0±6.6%，范围75 - 93%）为12.6±7.8%（范围5 - 25%）。临床症状消失或减轻。未发生严重并发症。
球囊扩张支架血管成形术治疗椎动脉V2段狭窄似乎可行且有效。需要进行更大样本量的进一步研究。
