椎动脉开口狭窄支架置入的的疗效观察.doc

椎动脉开口狭窄支架置入的的疗效观察 　　[摘要] 目的 探讨支架置入治疗症状性椎动脉开口狭窄的临床疗效。 方法 回顾性分析支架置入治疗椎动脉开口狭窄26例患者，通过血管造影术，观察椎动脉狭窄对患者脑血流的客观影响，对椎动脉狭窄50%的症状性患者进行血管内介入治疗。 结果 手术全部成功，26例患者在支架放置术中均没有发生斑块脱落而造成脑栓塞，随访6～38个月，平均（18.0±4.3）个月，随访期间经DSA或CTA复查，21例椎动脉形态良好，1例失访，3例出现轻中度再狭窄，1例重度狭窄。 结论 支架置入技术上是安全的，疗效满意，术后综合治疗降低了患者再次发生症状性缺血事件的风险，脑缺血症状的改善非常明显。 　　[关键词] 椎动脉狭窄；椎动脉开口；卒中；支架置入 　　[中图分类号] R654.3 [文献标识码] A [文章编号] 2095-0616（2013）14-15-03 　　Effect observation of stent placement in symptomatic vertebral artery ostium stenosis 　　HE Liming1 LIU Baoguo1 ZHANG Guozhong2 XIAO Gang1 YAO Chen1 　　1.Department of Neurosurgery， Yuebei Peoples Hospital， Shaoguan 512026， China；2. Department of Neurosurgery， Nanfang Hospital， Guangzhou 510515， China 　　[Abstract] Objective To investigate the clinical effect of stent placement in the treatment of symptomatic vertebral artery ostium stenosis. Methods 26 cases with vertebral artery ostial stenosis done stent placement were retrospectively analyzed. The objective influence of vertebral artery stenosis on the patients were observed by angiography， and the patients whose symptomatic vertebral artery stenosis were greater than 50% were treated by endovascular intervention. Results The operations on all patients were successful， and no falling plaques and the subsequent cerebral thrombosis； the follow-up lasted for 6-38 months， and the average were （18.0±4.3） months， and during which period the review of DSA or CTA showed that the vertebral artery of 21 cases were in a good state， one case was not examined， 3 cases returned to mild and moderate stenosis， 1 case returned to severe stenosis. Conclusion Stent placement is safe technology and has satisfactory effect， and the after-operational comprehensive treatment can reduce the risk of the recurrence of symptomatic ischemic events， and the symptom of cerebral ischemia is greatly improved. 　　[Key words] Vertebral artery stenosis； Vertebral artery ostium； Stroke； Stent placement 　　颈动脉和冠状动脉粥样硬化斑块是公认的缺血原因，而椎动脉开口（VAO）处动脉粥样硬化斑块不被公认为缺血性中