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目的探讨Vaso CT检查的影像特征对椎-基底动脉结合部闭塞再通术的风险评估、指导作用及临床价值。方法回顾性纳入解放军总医院神经内科2016年1月至2017年5月收治的14例椎-基底动脉结合部闭塞患者,术前均行全脑DSA确认椎-基底动脉结合部闭塞,采用Vaso CT测量闭塞血管长度及其两端血管走形,根据结果评估手术风险并指导椎-基底动脉结合部闭塞再通术。结果 14例患者椎-基底动脉结合部闭塞血管长度为2.56~19.09 mm,平均(4.5±2.1)mm,对其中13例患者行椎-基底动脉闭塞再通术,12例患者血管成功开通,并均于血管开通后行支架置入术,其中置入Solitaire支架8枚及Wingspan支架4枚;1例患者因闭塞长度较长(19.09 mm)而未进行血管开通术。所有手术患者未发生围手术期并发症,术后患者神经功能症状均明显改善。结论 Vaso CT可对椎-基底动脉结合部闭塞开通术的手术风险进行准确判断,并可指导手术路径,降低患者围手术期并发症发生风险,提高手术成功率。
Objective To investigate the risk assessment, instructive effect and clinical value of Vaso CT in detecting occlusion of vertebrobasilar artery occlusion. Methods We retrospectively included 14 patients with vertebro-basilar artery occlusion in the Department of Neurology, PLA General Hospital from January 2016 to May 2017. Preoperative DSA was used to confirm the occlusion of vertebro-basilar junction. Vaso CT The length of the occluded vessel and the shape of the vessels at both ends of the vessel were measured. According to the results, the surgical risk was evaluated and the occlusion of the vertebrobasilar artery was occluded. Results The length of occlusion of vertebrobasilar junction in 14 patients was 2.56-19.09 mm (mean 4.5 ± 2.1 mm). Thirteen patients underwent vertebro-basilar artery occlusion recanalization and the vessels of 12 patients were successfully opened. All of them were implanted with 8 Solitaire stents and 4 Wingspan stents after opening of the blood vessels. One patient was not opened due to the longer occlusion length (19.09 mm). Perioperative complications did not occur in all surgical patients, neurological symptoms were significantly improved in patients after surgery. Conclusion Vaso CT can accurately judge the operation risk of vertebrobasilar artery occlusion and guide the operation path, reduce the risk of perioperative complications and improve the success rate of operation.