CAJ | 학술논문

目的：探讨腔内治疗锁骨下动脉盗血综合征（SSS）的临床疗效与安全性。方法2005年4月-2013年2月对12例 SSS 患者（锁骨下动脉狭窄7例，闭塞5例）行腔内治疗，其中单纯经皮血管球囊成形术（PTA）4例，支架植入8例（8枚支架）。结果手术成功率为100%（12/12）。患/健侧收缩压比由术前0．46±0．28提高至术后的0．89±0．32，差异有统计学意义（P <0．05）。术后患者临床症状均不同程度改善，随访16．7±7．9个月，1例左侧锁骨下动脉闭塞患者 PTA 术后13个月再狭窄，给予支架治疗后好转；1例锁骨下动脉重度狭窄患者 PTA 术后23 d 出现患肢末梢微血管栓塞，经改善微循环、扩血管等治疗后好转，无脑卒中等严重并发症发生。结论腔内治疗 SSS 是微创、安全、有效的治疗方法，能明显改善患者因盗血导致的椎-基底动脉供血不足的临床症状，改善患肢乏力、温度低等症状，值得临床上推广应用。
목적：탐토강내치료쇄골하동맥도혈종합정（SSS）적림상료효여안전성。방법2005년4월-2013년2월대12례 SSS 환자（쇄골하동맥협착7례，폐새5례）행강내치료，기중단순경피혈관구낭성형술（PTA）4례，지가식입8례（8매지가）。결과수술성공솔위100%（12/12）。환/건측수축압비유술전0．46±0．28제고지술후적0．89±0．32，차이유통계학의의（P <0．05）。술후환자림상증상균불동정도개선，수방16．7±7．9개월，1례좌측쇄골하동맥폐새환자 PTA 술후13개월재협착，급여지가치료후호전；1례쇄골하동맥중도협착환자 PTA 술후23 d 출현환지말소미혈관전새，경개선미순배、확혈관등치료후호전，무뇌졸중등엄중병발증발생。결론강내치료 SSS 시미창、안전、유효적치료방법，능명현개선환자인도혈도치적추-기저동맥공혈불족적림상증상，개선환지핍력、온도저등증상，치득림상상추엄응용。
Objective To investigate the efficacy and safety of endovascular treatment for subclavian steal syndrome (SSS). Methods During the period from April 2004 to Feb. 2013 at authors’ hospital, a total of 12 patients with SSS, including subclavian artery stenosis (n = 7) and occlusion (n = 5), underwent endovascular treatment. Percutaneous transluminal angioplasty (PTA) was carried out in 4 cases and stent implantation in 8 cases. The clinical data were retrospectively analyzed. Results Technical success rate was 100%(12/12). The diseased side/healthy side blood pressure ratio increased from preoperative (0.46 ± 0.28) to postoperative (0.89 ± 0.32), and the difference was statistically significant (P < 0.05). After the treatment, the clinical symptoms were improved in different degrees in all patients. During the follow - up period lasting for (16.7 ± 7.9) months, restenosis occurred in one case with left SSS thirteen months after PTA, and the condition was improved after stenting angioplasty. Another patient with severe subclavian artery stenosis developed peripheral micro- vascular thrombosis of the diseased limb in 23 days after PTA, which was relieved after medication to improve microcirculation and vasodilation. No severe complications such as stroke occurred. Conclusion For subclavian artery steal syndrome, endovascular management is a minimally invasive, safe and effective treatment. It can significantly relieve the clinical symptoms due to vertebral- basilar artery insufficiency caused by subclavian steal syndrome, and improve limb weakness, low body temperature, etc. Therefore, this technique should be recommended in clinical practice.