论文部分内容阅读
目的探讨经皮腔内血管支架成形术治疗颅内外血管狭窄。方法对16例颅内外脑血管狭窄的患者,由多学科参加进行术前评估后,行经皮腔内血管支架成形术治疗。结果16例患者中15例患者症状即刻消失或好转,术后残余狭窄率小于20%。其中1例因血管严重迂曲,支架无法到位,手术失败。1例因血压控制欠佳于术后48h出现高灌注综合征,继发颅内出血,经治疗后恢复良好。1例行颈内动脉支架植入术后出现持续低血压,经升压及补液对症治疗5d后血压正常。对15例患者术后随访3￣14个月,无患者发生再狭窄。结论经皮腔内血管支架成形术治疗颅内外血管狭窄创伤小、疗效好,但风险高,应注重术前评估、手术操作、并发症防治、围手术期监护及发挥团队协作精神。
Objective To investigate percutaneous transluminal angioplasty in the treatment of intracranial and extracranial vascular stenosis. Methods Sixteen patients with intracranial and extracranial vascular stenosis were treated by multidisciplinary preoperative evaluation and percutaneous transluminal angioplasty. Results Fifteen of the 16 patients disappeared or improved immediately. The residual stenosis rate was less than 20%. One case of severe blood vessel tortuosity, stent can not be put in place, the operation failed. 1 case of poor control of blood pressure after 48h appeared high perfusion syndrome, secondary intracranial hemorrhage, recovered well after treatment. 1 cases of continuous carotid artery stent implantation after sustained hypotension, pressure and rehydration symptomatic treatment 5d after normal blood pressure. Fifteen patients were followed up for 3 to 14 months without any restenosis. Conclusion Percutaneous transluminal angioplasty is a safe and effective method for the treatment of intracranial and extracranial vascular stenosis. However, the risk is high. Preoperative evaluation, surgical operation, prevention and treatment of complications, perioperative monitoring and team spirit should be emphasized.