摘要
目的：分析颈动脉盗血综合征（carotidstealsyndrome,CSS）患者的临床和影像学特征，探讨其代偿方式、诊断和治疗方法。方法收集CS S 患者的病史和影像学资料，对血管病变情况、侧支循环、治疗和预后进行分析。结果共纳入11例CSS 患者，男性8例，女性3例，平均年龄（66.7±5.1）岁。临床表现为后循环短暂性脑缺血发作（transient ischemic attack, TIA）9例（81.8％），后循环梗死1例（9.1％），前循环TIA 1例（9.1％）。总共发现19条病变血管，12条（63.1％）闭塞，2条（10.5％）次全闭塞，4条（21％）重度狭窄，1条（5.2％）动脉夹层分离。7例（63.6％）为双侧颈内动脉病变，3例（27.2％）为单侧颈内动脉病变，1例（9.1％）为双侧颈总动脉闭塞。11例患者均出现一级侧支循环，其中后交通动脉开放10例（90.9％），前交通动脉开放1例（9.1％）；出现二级侧支循环4例（36.3％），三级侧支循环1例（9.1％）。所有患者在危险因素管理基础上进行药物治疗，3例行支架置入术，2例行动脉内膜切除术，所有患者随访至2014年9月未发生卒中。结论 CSS患者的血管病变多发生在颈内动脉颅外段，一般通过Wil is环进行代偿供血，表现为被盗血动脉的缺血表现，确诊需依靠数字减影血管造影检查。在药物治疗基础上，部分患者可行手术或血管内介入治疗。
ObjectiveToanalyzetheclinicalandimagingcharacteristicsinpatientswithcarotidsteal syndrome （ CSS ） and to investigate its compensatory pathw ays, diagnosis, and treatment. Methods The medical history and imaging data of the patients with CSS were colected. Their vascular lesions, colateral circulation, treatment, and prognosis w ere analyzed. Results A total of 11 patients w ith CSS （8 males and 3 females, mean age 66.7 ±5.1 years） were enroled in the study. Their clinical manifestations were posterior circulation transient ischemic attack （TIA） （ n=9, 81.8%）, posterior circulation infarction （ n=1, 9.1%）, and anterior circulation TIA （ n=1, 9.1%）. A total of 19 pathological arteries w ere found：12 （63.1%） w ith occlusion, 2 （10.5%） w ith subtotal occlusion, 4 （21.0%） w ith severe stenosis and 1 （5.2%） w ith artery dissection. Seven patients （63.6%） w ere bilateral internal carotid artery lesions, 3 （27.2%） w ere unilateral bilateral internal carotid artery lesions, and 1 （9.1%） w as bilateral common carotid artery occlusion. Eleven patients had primary col ateral circulation, including posterior communicating artery patency in 10 patients （90.9%） and anterior communicating artery patency in 1 patient （9.1%）. Four patients （36.3%） had secondary col ateral circulation and 1 （9.1%） had tertiary col ateral circulation. Al patients w ere treated w ith medication on the basis of the management of risk factors. Three patients w ere treated w ith stenting and tw o were treated with carotid endarterectomy. No stroke occurred in al patients during folow -up til September 2014. Conclusions The vascular lesions of patients w ith CSS often occur in the extracranial segment of internal carotid artery. Usual y the compensatory blood is through the circle of Wil is. The presentation is ischemia in the stolen arteries. Its diagnosis needs to be examined by digital subtraction angiography. On the basis of medication therapy, some patients may be treated w ith s
出处
《国际脑血管病杂志》
2015年第2期91-96,共6页
International Journal of Cerebrovascular Diseases
基金
国家自然科学基金面上项目（81471195）
国家自然科学基金青年项目（81200894）
苏州市科技发展计划项目（SYSD2012083）
