CAJ | 학술논문

目的评价右锁骨下动脉狭窄或闭塞介入治疗技术与疗效.方法 8例右锁骨下动脉狭窄和9例闭塞患者,原发病14例动脉硬化、3例大动脉炎,男13例、女4例,平均年龄(56±11)岁,接受介入开通治疗.经股或联合经右肱动脉途径入路行动脉闭塞段的开通、球囊扩张及支架置入.其中6例应用颈动脉脑保护装置.结果 1例双向均未开通闭塞段,16例获得成功治疗.手术成功的患者中,狭窄和闭塞患者各8例,5例行单纯球囊扩张、11例球囊扩张后行支架置入,术后即刻血流通畅.完成治疗后6例脑保护装置均安全回收,无脑梗死事件发生.手术后随访1～ 66个月,平均(24±18)个月.术后10个月1例(置入支架者)再狭窄,球囊扩张后狭窄开通；1例大动脉炎患者术后18个月死于脑梗死；其余患者均无缺血症状再发,超声及CTA检查(9例患者)SA血流均通畅.结论球囊扩张及支架置入可安全、有效解决右锁骨下动脉狭窄和闭塞病变.
목적 평개우쇄골하동맥협착혹폐새개입치료기술여료효.방법 8례우쇄골하동맥협착화9례폐새환자,원발병14례동맥경화、3례대동맥염,남13례、녀4례,평균년령(56±11)세,접수개입개통치료.경고혹연합경우굉동맥도경입로행동맥폐새단적개통、구낭확장급지가치입.기중6례응용경동맥뇌보호장치.결과 1례쌍향균미개통폐새단,16례획득성공치료.수술성공적환자중,협착화폐새환자각8례,5례행단순구낭확장、11례구낭확장후행지가치입,술후즉각혈류통창.완성치료후6례뇌보호장치균안전회수,무뇌경사사건발생.수술후수방1～ 66개월,평균(24±18)개월.술후10개월1례(치입지가자)재협착,구낭확장후협착개통；1례대동맥염환자술후18개월사우뇌경사；기여환자균무결혈증상재발,초성급CTA검사(9례환자)SA혈류균통창.결론 구낭확장급지가치입가안전、유효해결우쇄골하동맥협착화폐새병변.
Objective To evaluate the technique and result of endovascular treatment for right subclavian artery stenosis or occlusion.Methods Seventeen patients [13 males,4 females ; (56 ± 11)years old] with right subclavian artery stenosis or occlusion were treated with endovascular surgery which included recanalization,balloon angioplasty and stenting via femoral or brachial artery route.Cerebral protection devices were used in 6 cases to avoid cerebral embolism.Results Sixteen of the seventeen patients acquired successful recanalization in 8 cases with subclavian artery stenosis (100％ technical success rate) and in other 8 cases with subclavian artery occlusion (88.9％ technical success rate).Five cases were treated with balloon angioplasty,and 11 cases were treated with balloon angioplasty combined with stenting.Good patency was seen in the 16 cases immediately after the procedure.The cerebral protection devices prevented all the cases from cerebral embolism and were retrieved suceessfully.Sixteen cases were followed up from 1 to 66 months [mean (24 ± 18) months].Restenosis was found in one case 10 months later and was successfully treated with re-PTA.One case with aortoarteritis died of cerebral infarction 18 months later.No symptom recurrence was found in other cases and ultrasound or CTA of followup showed excellent patency.Conclusions Balloon angioplasty and stenting are safe and effective for the treatment of right subclavian artery occlusion.