重叠多支架置入术治疗椎动脉延长扩张症的初步经验

发布时间：2018-04-09 02:15

本文选题：椎-基底动脉延长扩张　切入点：椎动脉　出处：《中国脑血管病杂志》2017年08期

【摘要】：目的初步探讨血管内重叠多支架置入治疗椎动脉延长扩张症的安全性和长期疗效。方法回顾性分析2009年5月至2011年1月第二军医大学附属长海医院神经外科采用重叠多枚支架置入治疗的3例椎动脉延长扩张症患者的临床及影像学资料。3例患者均为左侧颅内椎动脉延长扩张,1例左侧延髓受压伴右侧丘脑陈旧性梗死,1例合并左侧大脑后动脉破裂动脉瘤接受载瘤动脉弹簧圈闭塞术,1例左侧延髓腔梗合并左侧颅内椎动脉夹层。结果向每例患者左侧椎动脉内置入2~5枚LEO支架,完全覆盖病变;3例患者血流重建均成功,未出现围手术期并发症。对3例患者临床随访5~8年,无新发临床症状,改良Rankin量表评分均为0分;2例DSA随访血管形态较术前明显改善。结论初步经验显示,重叠多支架成形术治疗椎动脉延长扩张症是安全的,血管重建长期效果满意。
[Abstract]:Objective to evaluate the safety and long-term efficacy of endovascular overlapping stent placement in the treatment of vertebral artery dilatation.Methods from May 2009 to January 2011, the clinical and imaging data of 3 patients with vertebral artery dilatation treated with overlapping stents in the neurosurgery department of Changhai Hospital affiliated to the second military Medical University were analyzed retrospectively.All of them were left intracranial vertebral artery lengthening and dilatation. One case was left medulla compression with right thalamic old infarction. One case was complicated by left posterior cerebral artery ruptured aneurysm. One case was left medullary infarction with left medulla obliteration combined with left medullary infarction.Lateral intracranial vertebral artery dissection.Results two or five LEO stents were inserted into the left vertebral artery of each patient.Three patients were followed up for 5 ~ 8 years. There were no new clinical symptoms. The scores of modified Rankin scale were 0 and the vascular morphology of 2 patients with DSA was significantly improved compared with that before operation.Conclusion it is safe to treat vertebral artery dilatation with overlapping multi-stent angioplasty, and the long-term effect of vascular reconstruction is satisfactory.
【作者单位】：第二军医大学附属长海医院神经外科;
【基金】：国家重点研发项目(2016YFC1300700) 上海市科委创新行动计划项目(13411950300);上海市科委项目(14441904702)
【分类号】：R651.12

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