CAJ | 학술논문

目的研究血管内支架成形术治疗症状性大脑中动脉狭窄的疗效及安全性.方法对27例症状性大脑中动脉狭窄患者行血管腔内成形术.结果 27例患者中,24例成功置入冠脉支架,术后即刻造影显示狭窄程度为(8±4)%,较术前(80±19)%改善明显.2例因支架置入困难改行经皮血管腔内成形术(PTA).平均随访18个月.25例患者术后短暂性脑缺血发作均未发生.无责任血管区新发脑梗死.1例支架置人后3 h发生再灌注性脑出血.1例支架脱落后于颈内动脉虹吸部,后用抓捕器取出.1例支架置人术后6个月发生再狭窄.结论经皮血管内支架成形术是治疗症状性大脑中动脉狭窄的一种较安全有效的方法.长期疗效有待干进一步观察.
목적 연구혈관내지가성형술치료증상성대뇌중동맥협착적료효급안전성.방법 대27례증상성대뇌중동맥협착환자행혈관강내성형술.결과 27례환자중,24례성공치입관맥지가,술후즉각조영현시협착정도위(8±4)%,교술전(80±19)%개선명현.2례인지가치입곤난개행경피혈관강내성형술(PTA).평균수방18개월.25례환자술후단잠성뇌결혈발작균미발생.무책임혈관구신발뇌경사.1례지가치인후3 h발생재관주성뇌출혈.1례지가탈락후우경내동맥홍흡부,후용조포기취출.1례지가치인술후6개월발생재협착.결론 경피혈관내지가성형술시치료증상성대뇌중동맥협착적일충교안전유효적방법.장기료효유대간진일보관찰.
Objective To investigate the safety and feasibility of endovascular stent angioplasty in treating symptomatic stenosis of middle cerebral artery.Methods Endovascular angioplasty with coronary stents was performed in 27 patients with symptomatic stenosis of middle cerebral artery.The clinical results were reviewed and analyzed.Results Of the total 27 patients,successful placement of the coronary stents Was achieved in 24.Angiography immediately after the procedure showed that the stenotic degree of the diseased artery was markedly decreased from preoperative (80±19)%to postoperative (8±4)%,the improvement was very obvious.Percutaneous transcatheter angioplasty had to be employed in two cases because of the failure of stent placement.A mean follow-up period of 18 months was carried out.During the following up period no transient cerebral ischemia attack occurred in 25 patients and no newly-developed cerebral infarction in region fed by the responsible vessels occurred either.Re=irrigation cerebral hemorrhage was seen in one patient,which occurred three hours after the placement of the stent.In one case the placed stent fell off and immigrated into the siphon of internal carotid artery,and the displaced stent Was took out later with a catching apparatus.In another case re-stenosis occurred six months after the stenting.Conclusion Percutaneous endovaacular stent angioplasty is a safe and effective treatment for symptomatic stenosis of middle cerebral artery,although its long-term results need to be further evaluated.