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  • 邓晓东,杨志刚,张磊,黄清海,许奕,赵文元,刘建民,洪波.Solitaire支架治疗复杂症状性颅内动脉狭窄的初步评价[J].第二军医大学学报,2013,34(5):521-525    [点击复制]
  • DENG Xiao-dong,YANG Zhi-gang,ZHANG Lei,HUANG Qing-hai,XU Yi,ZHAO Wen-yuan,LIU Jian-min,HONG Bo.Solitaire stent placement for treatment of complex intracranial arterial stenosis: a preliminary result[J].第二军医大学学报,2013,34(5):521-525   [点击复制]
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Solitaire支架治疗复杂症状性颅内动脉狭窄的初步评价
邓晓东,杨志刚,张磊,黄清海,许奕,赵文元,刘建民*,洪波*
0
(第二军医大学长海医院神经外科,上海 200433
共同第一作者
*通信作者)
摘要:
目的 分析Solitaire支架治疗复杂症状性颅内动脉狭窄的可行性、安全性和有效性。方法 收集2010年11月至2012年6月第二军医大学长海医院临床神经医学中心18例以Solitaire支架治疗的症状性颅内动脉狭窄患者的临床和影像学资料,回顾性分析狭窄形态学、病变血管径路条件、手术技术成功率、围手术期并发症率,总结近期临床及影像随访结果。结果 患者男8例、女10例;平均(66.55±9.84)岁。狭窄病变的Mori分型:A型5例,B型8例,C型5例;血管径路依据LMA分型:良好2例,适度迂曲12例,严重迂曲4例。所有患者均成功行Solitaire支架成形术,术前狭窄程度为(74±12.5)%,术后残余狭窄程度为(10±5.5)%。1例患者术后发生手术血管供血区新发脑梗死,手术并发症率为5.6%。术后临床平均随访(6.2±1.4)个月,无治疗血管相关脑缺血事件发生。血管影像随访15例(CTA或DSA),平均随访(7.8±2.6)个月。随访期间3例发生支架内再狭窄,再狭窄率20%,其中1例有短暂性缺血发作,另2例无临床症状。 结论 Solitaire支架治疗复杂症状性颅内动脉狭窄可行、安全,近期随访疗效确切,但相关结论仍有待进一步的大样本研究证实。
关键词:  颅内动脉硬化  狭窄  血管成形术  Solitaire支架
DOI:10.3724/SP.J.1008.2013.00521
投稿时间:2012-12-10最后修改时间:2013-03-20
基金项目:
Solitaire stent placement for treatment of complex intracranial arterial stenosis: a preliminary result
DENG Xiao-dong,YANG Zhi-gang,ZHANG Lei,HUANG Qing-hai,XU Yi,ZHAO Wen-yuan,LIU Jian-min*,HONG Bo*
(Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
Co-first authors.
*Corresponding authors.)
Abstract:
Objective To evaluate the feasibility, safety and efficacy of Solitaire stent placement for treatment of complex intracranial atherosclerotic stenosis. Methods We retrospectively reviewed the clinical data of 18 patients who underwent Solitaire stent placement for symptomatic intracranial arterial stenoses in our department between November 2011 and June 2012, with focus on the stenosis morphology, condition of the diseased blood vessels, surgical success rate, and perioperative complications. We also summarized the early outcomes and imaging findings during follow-up. Results The patients included 8 males and 10 females, with a mean age of 66.55±9.84 years old. Mori typing results were 5 A, 8 B, and 5 C types; LMA typing results were good in 2, moderate tortuosity in 12, severe tortuosity in 4 cases. All the patients received successful Solitaire stent implantation. The average stenosis rate was reduced from (74±12.5)% to (10±5.5)% after the procedure. There was only one patient (5.6%) had post-operative complication (cerebral infarction of the target vessel territory),who had temporal symptom and recovered well at follow-up.Clinical follow-up was available for 18 patients, with a mean of 6.2± 1.4 months; and no patients experienced any ischemic episodes. Fifteen patients had DSA or CTA follow-up for a mean of 7.8±2.6 months. There were 3 in-stent restenosis (20%) cases and one of them was symptomatic with transient ischemic attack. Conclusion Solitaire stent placement is feasible, safe and effective for complex symptomatic intracranial artery stenosis, with definite short-term effectiveness, and the long-term effect warrants further investigation.
Key words:  intracranial arteriosclerosis  stenosis  angioplasty  solitaire stents