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目的回顾性分析应用wingspan支架对症状性颅内椎基底动脉狭窄的治疗情况,评价其安全性及有效性。方法应用wingspan支架治疗症状性颅内椎基底动脉狭窄患者28例,观察其技术成功率、狭窄率的改变、围手术期并发症及术后症状改善情况。结果(1)28例患者共置入29枚wingspan支架,技术成功率100%。(2)术后即刻血管造影证实,狭窄率由(77.4±8.2)%降为(21.4±7.9)%。(3)2例(7.1%)患者出现围手术期并发症,考虑为穿支动脉闭塞。(4)28例患者术后随访6～21个月,按照malek评分,分别评价术后当时(24h内),术后1个月及最近时间预后情况,术后当时malek评分:1分26例(92.9%),4分2例(7.1%);1个月后评分:1分25例(89.3%),4分2例(7.1%),5分1例(3.6%)(术后2周死于肺部感染导致的呼吸衰竭)。最近随访术后6个月到21个月,平均(12.7±3.4)个月:1分24例(85.7%),3分1例(3.6%),5分2例(7.1%)(另一患者术后7个月死于脑出血),失访1例(3.6%)。结论应用wingspan支架治疗症状性颅内椎基底动脉具有较好的安全性及短期疗效,其长期疗效还需进一步随访。
Objective To retrospectively analyze the treatment of symptomatic intracranial vertebrobasilar artery stenosis with the wingspan stent and evaluate its safety and efficacy. Methods 28 patients with symptomatic intracranial vertebrobasilar artery stenosis were treated with the wingspan stent. The changes of technical success rate, stenosis rate, perioperative complications and postoperative symptoms were observed. Results (1) A total of 29 wingspan stents were placed in 28 patients with a technical success rate of 100%. (2) Immediate angiography confirmed that the stenosis rate decreased from (77.4 ± 8.2)% to (21.4 ± 7.9)%. (3) Perioperative complications occurred in 2 patients (7.1%), considered as perforator artery occlusion. (4) Twenty-eight patients were followed up for 6 to 21 months. According to the malek score, the prognosis of the patients at the time (within 24h), one month after surgery and the most recent time were evaluated. The malek score at the time after operation was 1 point and 26 cases (92.9%) in 4 cases and 2 cases (7.1%) in 4 cases. The score of 1 month was 25 cases (89.3%) in 1 point, 2 cases (7.1%) in 4 points and 1 case Zhou died of respiratory failure caused by pulmonary infection). The most recent follow-up ranged from 6 months to 21 months after operation, with an average of (12.7 ± 3.4) months: 1 in 24 patients (85.7%), 3 in 1 patient (3.6%), 5 in 2 patients (7.1%) The patient died of cerebral hemorrhage 7 months after surgery), and one patient lost follow-up (3.6%). Conclusion The application of the wingspan stent in the treatment of symptomatic intracranial vertebrobasilar artery has good safety and short-term curative effect, and its long-term curative effect needs further follow-up.