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目的:探讨放疗后颈部血管狭窄的发病机制、临床及影像学特点、血管内支架治疗的可行性。方法:分析2例放疗后血管狭窄患者的临床资料,并结合文献复习进行总结和讨论。结果:2例男性患者分别为64、69岁,发病时间为放疗后10和30年。全脑血管造影(DSA)示病变血管在放射野中心位置,血管狭窄严重,分布狭长。行颈内动脉,锁骨下动脉血管内支架治疗后,给予抗血小板聚集、他汀类药物调节血脂等治疗。随访1年,患者恢复良好,未出现局灶性神经功能缺失症状。结论:放疗可引起颈动脉狭窄,需引起重视并注意随访,可行MRA、CTA、DSA进行确诊,必要时行血管内支架干预。
Objective: To investigate the pathogenesis, clinical and radiological features of cervical stenosis after radiotherapy and the feasibility of endovascular stent. Methods: The clinical data of 2 patients with vascular stenosis after radiotherapy were analyzed and summarized with the review of the literature. Results: Two male patients were 64 and 69 years old, respectively. The onset time was 10 and 30 years after radiotherapy. Cerebral angiography (DSA) showed vascular lesions in the center of the radial field, severe vascular stenosis, the distribution of long and narrow. Carotid artery, subclavian artery stent treatment, given anti-platelet aggregation, statins, such as the regulation of blood lipids treatment. After a follow-up of 1 year, the patient recovered well and no symptoms of focal neurological deficit occurred. Conclusion: Radiotherapy can cause carotid artery stenosis. It is necessary to pay attention to and pay attention to follow-up. MRA, CTA and DSA can be used to diagnose carotid artery. If necessary, endovascular stent intervention is performed.