Touho H, Takaoka M, Ohnishi H, Furuoka N, Karasawa J
Department of Neurosurgery, Osaka Neurological Institute, Japan.
Surg Neurol. 1995 Jan;43(1):42-7. doi: 10.1016/0090-3019(95)80036-g.
The Stealth dilation catheter was used for the intravascular treatment of a patient who had hemodynamically significant stenosis of the posterior cerebral artery and had a history of recurrent transient ischemic attacks associated with right hemiparesis and ipsilateral hemianopia dating from March 1993. Cerebral perfusion studies prior to and after the intravenous administration of acetazolamide demonstrated regions of moderately low perfusion and low hemodynamic reserve in the territories of the left middle and posterior cerebral arteries. Cerebral angiograms demonstrated severe stenosis of the left posterior cerebral artery and occlusions of both middle cerebral arteries, which had leptomeningeal anastomoses with the posterior cerebral arteries. Percutaneous transluminal angioplasty (PTA) was performed using the Stealth catheter on the stenotic segment of the left posterior cerebral artery after left superficial temporal artery-middle cerebral artery anastomosis. The patient manifested marked improvement in her neurologic condition just after PTA, in association with marked increase in cerebral perfusion and hemodynamic reserve in the territories of the left middle and posterior cerebral arteries. We have presented evidence that PTA can be used to treat patients with stenosis of the first segment of the posterior cerebral artery and hemodynamic compromise in the territory that artery supplies.
使用隐形扩张导管对一名患有大脑后动脉血流动力学显著狭窄且有复发性短暂性脑缺血发作病史（自1993年3月起伴有右侧偏瘫和同侧偏盲）的患者进行血管内治疗。静脉注射乙酰唑胺前后的脑灌注研究显示，在左大脑中动脉和大脑后动脉供血区域存在中度低灌注和低血流动力学储备区域。脑血管造影显示左大脑后动脉严重狭窄，双侧大脑中动脉闭塞，与大脑后动脉有软脑膜吻合。在左颞浅动脉 - 大脑中动脉吻合术后，使用隐形导管对左大脑后动脉狭窄段进行经皮腔内血管成形术（PTA）。患者在PTA后立即出现神经功能状况明显改善，同时左大脑中动脉和大脑后动脉供血区域的脑灌注和血流动力学储备显著增加。我们已证明PTA可用于治疗大脑后动脉第一段狭窄且该动脉供血区域存在血流动力学损害的患者。
