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目的探讨颅内动脉支架置入术治疗症状性颅内动脉狭窄的有效性,安全性,以及近期临床疗效及围手术期并发症的防治。方法对入选的68例颅内动脉狭窄的患者,于颈内动脉颅内段、大脑中动脉、椎动脉颅内段及基底动脉狭窄处行支架置入治疗,手术前后对患者行经颅脑多普勒超声(TCD)检查,评估颅内血流动力学情况;临床症状体征变化采用美国国立卫生研究院卒中量表评分(NIHSS);血管狭窄采用华法令-阿司匹林症状性颅内动脉病变(WASID)标准计算术前术后狭窄率;对术后所有病例进行短期(3～6个月)随访。结果 68例患者共置入73枚支架,手术成功率为95.59%,其中3例因颅内血管过度迂曲,支架未能达到狭窄部位,余支架置入均一次成功,支架位置准确,膨胀良好,血流通畅。1例术中出现血管痉挛,2例出现新发颅内缺血事件,2例出现颅内出血,余患者均反应良好。结论血管内支架置入术治疗颅内动脉狭窄安全性高、创伤性小,近期疗效明显,远期疗效有待进一步研究。
Objective To investigate the effectiveness and safety of intracranial arterial stenting in the treatment of symptomatic intracranial arterial stenosis and its clinical efficacy and prevention and treatment of perioperative complications. Methods A total of 68 patients with intracranial stenosis were treated with stent implantation in the intracranial internal carotid artery, middle cerebral artery, intracranial of vertebral artery and basilar artery stenosis. (TCD) to assess intracranial hemodynamics; clinical signs and symptoms were assessed using National Institutes of Health Stroke Scale (NIHSS); vascular stenosis with warfarin-aspirin-induced intracranial arterial disease (WASID) Standard calculation of preoperative and postoperative stenosis rate; all cases were short-term (3 to 6 months) follow-up. Results A total of 73 stents were implanted in 68 patients. The success rate of operation was 95.59%. Three of them had a tortuous intracranial vessel. The stent failed to reach the stenosis site. The remaining stent was successfully implanted. The position of stent was accurate and the swelling was good. Smooth blood flow. One case had vasospasm, two cases of new intracranial ischemia, two cases of intracranial hemorrhage, and the rest of the patients responded well. Conclusion Intracoronary stenting is safe and traumatic for the treatment of intracranial arterial stenosis. The short-term curative effect is obvious. Long-term curative effect remains to be further studied.