CAJ | 학술논문

目的：探讨血管内支架置入治疗鼻咽癌放疗后主动脉弓上动脉狭窄病变的疗效。方法回顾性分析8例鼻咽癌放疗后症状性主动脉弓上动脉中重度狭窄行血管内支架置入术患者的临床资料，观察治疗后脑缺血症状的改善情况。通过颈部血管彩色多普勒血流显像随访。结果8例患者均经全脑DSA证实，主动脉弓上颅外段共有中重度狭窄动脉24处，其中包括颈内动脉11处，颈总动脉2处，椎动脉10处，锁骨下动脉1处。（1）经血管扩张成形及支架置入后，血管腔残余狭窄率平均＜20％。术后复查头部 CT未见出血。术后定期复查颈部血管彩色多普勒血流显像，显示血管形态良好，血流通畅，未见支架内血栓形成及再狭窄，无过度灌注等不良事件发生。（2）随访1年所有患者无再发脑缺血症状，颈部血管彩色多普勒血流显像未发现明显再狭窄。结论血管内支架置入是鼻咽癌放疗后主动脉弓上动脉狭窄可以选择的治疗方法。
목적：탐토혈관내지가치입치료비인암방료후주동맥궁상동맥협착병변적료효。방법회고성분석8례비인암방료후증상성주동맥궁상동맥중중도협착행혈관내지가치입술환자적림상자료，관찰치료후뇌결혈증상적개선정황。통과경부혈관채색다보륵혈류현상수방。결과8례환자균경전뇌DSA증실，주동맥궁상로외단공유중중도협착동맥24처，기중포괄경내동맥11처，경총동맥2처，추동맥10처，쇄골하동맥1처。（1）경혈관확장성형급지가치입후，혈관강잔여협착솔평균＜20％。술후복사두부 CT미견출혈。술후정기복사경부혈관채색다보륵혈류현상，현시혈관형태량호，혈류통창，미견지가내혈전형성급재협착，무과도관주등불량사건발생。（2）수방1년소유환자무재발뇌결혈증상，경부혈관채색다보륵혈류현상미발현명현재협착。결론혈관내지가치입시비인암방료후주동맥궁상동맥협착가이선택적치료방법。
Objective To investigate the efficacy of endovascular stenting for aortic arch artery stenosis after nasopharyngeal carcinoma radiotherapy. Methods The clinical data of 8 patients with symptomatic severe aortic arch artery stenosis after nasopharyngeal carcinoma radiotherapy were analyzed retrospectively. The patients were all received endovascular stenting,and their improvement of cerebral ischemic symptoms was observed. They were followed up by cervical color Doppler ultrasound.Results The whole brain vascular DSA confirmed that there were 24 severe arterial stenoses on the aortic arch arteries of extracranial segments in 8 patients,including 11 in internal carotid artery,2 in common carotid artery,10 in vertebral artery and 1 in subclavian artery. The patients were treated with vascular angioplasty and stenting respectively. All the patients were followed up for 1 year;there were no recurrence of cerebral ischemic symptoms.Cervical color Doppler ultrasound did not reveal any obvious restenosis. Conclusion Endovascular stent angioplasty for the treatment of aortic arch artery stenosis after nasopharyngeal carcinoma radiotherapy is relatively safe and feasible.