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慢性闭塞性椎动脉的血管内血运重建:单中心经验

Endovascular revascularization of chronically occluded vertebral artery: single-center experience.

作者信息

Cai Xueli, Huang Liangtong, Chen Xueping, Sun Jingping, Gao Feng

机构信息

Department of Neurology, The Second Afliated Hospital, Zhejiang University, School of Medicine, Hangzhou, Zhejiang, China.

Department of Neurology, Lishui Hospital of Zhejiang University (Lishui Municipal Central Hospital), Lishui, Zhejiang, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):211-218. doi: 10.5114/wiitm.2020.97445. Epub 2020 Jul 27.

Abstract

INTRODUCTION

Chronic vertebral basilar artery occlusion is one of the most common causes of ischemic stroke, which accounts for roughly 20% of all cases. However, the evidence for the precise clinical effect in treatment of the initial segment of chronic vertebral basilar artery occlusion is not sufficient.

AIM

To evaluate the feasibility and efficacy of endovascular therapy in the initial segment of chronic vertebral basilar artery occlusion.

MATERIAL AND METHODS

This is a retrospective study based on data obtained from Lishui Hospital of Zhejiang University. We identified patients who underwent treatment for initial segment occlusion of the vertebral basilar artery from September 2014 to September 2018.

RESULTS

Among a total of twenty-two subjects, 77.27% of them were men and the median age was 61 years old. The primary medical history of these patients included hypertension (15, 68.18%), hyperlipidemia (13, 59.09%), diabetes mellitus (11, 50.00%), and coronary artery disease (6, 27.27%). About 54.54% of the patients were current smokers. Successful recanalization was achieved in 86.36% of patients. Five cases of balloon dilatation were recanalized and fourteen cases were treated by balloon dilation combined with stent implantation. During the follow-up period, there were no recurrent cerebral ischemic events, including or stroke. Six (27.27%) arteries were found to exhibit angiographic re-stenosis.

CONCLUSIONS

The clinical effect of balloon dilatation or balloon dilatation combined with stenting in the treatment of chronic vertebral basilar artery occlusion in the beginning segment was feasible and safe.

摘要

引言

慢性椎基底动脉闭塞是缺血性卒中最常见的病因之一,约占所有病例的20%。然而,关于慢性椎基底动脉闭塞起始段治疗的确切临床效果的证据并不充分。

目的

评估血管内治疗慢性椎基底动脉闭塞起始段的可行性和疗效。

材料与方法

这是一项基于浙江大学丽水医院数据的回顾性研究。我们纳入了2014年9月至2018年9月期间接受椎基底动脉起始段闭塞治疗的患者。

结果

在总共22名受试者中,77.27%为男性,中位年龄为61岁。这些患者的主要病史包括高血压(15例,68.18%)、高脂血症(13例,59.09%)、糖尿病(11例,50.00%)和冠状动脉疾病(6例,27.27%)。约54.54%的患者为现吸烟者。86.36%的患者实现了成功再通。5例球囊扩张实现再通,14例采用球囊扩张联合支架植入治疗。在随访期间,没有复发性脑缺血事件,包括短暂性脑缺血发作或卒中。发现6条(27.27%)动脉出现血管造影再狭窄。

结论

球囊扩张或球囊扩张联合支架置入治疗慢性椎基底动脉闭塞起始段的临床效果是可行且安全的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f3bd/7991923/c118ba1671e1/WIITM-16-41379-g001.jpg

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