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目的探讨应用血管内支架治疗锁骨下动脉狭窄闭塞性病变的疗效。方法 21例(21支)锁骨下动脉狭窄或闭塞性病变患者接受血管内支架置入治疗,其中左锁骨下动脉近段重度狭窄13例、闭塞6例,右锁骨下动脉近段重度狭窄2例。支架置入路径为经股动脉穿刺插管或经肱动脉穿刺逆行插管。结果 21例患者锁骨下动脉均成功置入内支架(均为自膨式支架),术后患侧桡动脉、肱动脉搏动恢复正常,椎动脉显影良好,原有窃血现象消失。21例均先行股动脉穿刺置管,其中17例顺利置入支架,4例锁骨下动脉完全闭塞患者改用经患侧肱动脉逆行穿刺置入支架。随访发现1例患者1年后复发锁骨下动脉轻度狭窄。结论血管内支架置入术治疗锁骨下动脉狭窄、闭塞性病变是一种安全、有效的微创治疗方法。
Objective To investigate the curative effect of endovascular stent for the treatment of occlusive subclavian artery stenosis. Methods Twenty-one patients (21 patients) with subclavian artery stenosis or occlusive disease were treated with endovascular stenting, including 13 cases of severe proximal narrowing of the left subclavian artery, 6 cases of occlusion and 2 cases of severe proximal narrowing of the right subclavian artery . Stent placement path through the femoral artery puncture cannula or retrograde intubation through the brachial artery. Results All 21 patients underwent successful subclavian artery stent implantation (both self-expanding stents). The posterior ipsilateral radial artery and brachial artery returned to normal, the vertebral artery developed well and the original steal phenomenon disappeared. Twenty-one cases were treated with femoral artery catheterization, of which 17 cases were successfully placed in the stent. Four patients with complete occlusion of the subclavian artery were replaced with retrograde puncture through the affected brachial artery. Follow-up found 1 patient relapsed after 1 year subclavian artery mild stenosis. Conclusion Endovascular stenting is a safe and effective minimally invasive treatment for subclavian artery stenosis and occlusive disease.