摘要
目的探讨症状性动脉粥样硬化性颅内动脉长节段闭塞患者血管成形术中置入37mm长Enterprise支架治疗的效果和安全性。方法 27例症状性颅内动脉粥样硬化性长节段闭塞患者,术中亚满意球囊扩张后采用37 mm长Enterprise支架行血管成形术。记录手术情况,术后30d行改良Rankin量表(modified Rankin scale,mRS)评分评定治疗效果;比较术前1d及术后3、30d美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分;观察术后30d神经系统并发症发生情况;随访3～12个月,行数字减影血管造影或CT血管造影,观察管腔再狭窄发生情况。结果 3例微导丝未通过闭塞段,24例成功置入支架、血管再通,置入支架后管腔残余狭窄率为(19.2±6.9)%;术后30d治疗效果为优10例,良9例,差5例;术后3、30dNIHSS评分[(8.2±2.0)、(6.1±1.9)分]均较术前[(10.6±2.2)分]降低(P<0.05);术后30d内发生缺血性脑卒中1例,造影剂外渗1例;平均随访7.8个月,6例发生管腔再狭窄。结论对症状性动脉粥样硬化性颅内动脉长节段闭塞患者,血管成形术中亚满意球囊扩张后置入37mm长Enterprise支架治疗效果满意,并发症及远期管腔再狭窄发生率较低。
Objective To investigate the effect and safety of 37 mm Enterprise stent in the treatment of symptomatic atherosclerotic long-segment intracranial arterial occlusion. Methods Twenty-four patients with symptomatic atherosclerotic long-segment intracranial arterial occlusion were treated with subsatisfactory balloon dilatation,followed by 37 mm Enterprise stent for angioplasty.The surgical procedure was recorded,and modified Rankin scale(mRS)score was used to evaluate the therapeutic effect on day 30 after operation.National Institute of Health Stroke Scale(NIHSS)score was compared 1dbefore as well as on day 3 and 30 after operation.Neurological complications were observed on day 30 after operation.DSA or CTA was performed to observe the restenosis rate in 3-to 12-month follow-up survey.Results Successful stent implantation was performed in the occlusive lesions in 24 patients.The mean stenosis rate of the residual segment after stent implantation was(19.2±6.9)%.The results were excellent in 10 patients,good in 9and poor in 5on day 30 after operation.NIHSS score was significantly lower on day 3 and 30 after operation(8.2±2.0,6.1±1.9)than that before operation(10.6±2.2)(P<0.05).Ischemic stroke occurred in 1patient,and extravascular contrast agent extravasation occurred in l.The 7.8-month follow-up survey showed restenosis in 6 patients.Conclusion Subsatisfactory balloon dilatation combined with 37 mm Enterprise stent achieves a good result for symptomatic atherosclerotic long-segment intracranial arterial occlusion,with low perioperative complication rate and long-term restenosis rate.
作者
张坤
朱良付
李天晓
吴立恒
周志龙
贺迎坤
李立
ZHANG Kun;ZHU Liangfu;LI Tianxiao;WU Liheng;ZHOU Zhilong;HE Yingkun;LI Li(Department of Interventional Therapy,Henan Provincial People's Hospital, People's Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华实用诊断与治疗杂志》
2019年第1期29-31,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(81601583)
河南省2018年科技发展计划(182102310658)
