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目的总结比较颅内外脑动脉狭窄血管内支架成形术治疗技术操作的难易度,进行风险与收益的评估。方法将本院神经内科2004年1月至2008年12月间,接受经皮腔内支架成形术的110例患者分成颅内段、颅外段两组,颅内血管42例,颅外68例。支架置入点均为引起缺血事件的“责任”血管。对两组患者技术操作、术后并发症、短期随访(平均21±10.3个月)分别进行统计学处理。结果颅外68例技术操作全部成功,术中并发症10例,为颈内动脉开口支架成形术中出现的短暂心率、血压下降。颅内42例技术操作39例成功,术后脑出血1例(死亡),支架内血栓形成3例,血管痉挛2例。结论颅内血管支架成形术技术操作难度大,而且存在一定的风险性,实施时应慎重;颅外血管支架置入成形术可操作性相对较大,成功率较高,风险相对较小,收益较大;
OBJECTIVE: To compare the ease of operation of intracranial and extracranial arterial stenosis with endovascular stenting and assess the risks and benefits. Methods From January 2004 to December 2008, 110 patients who underwent percutaneous transluminal angioplasty were divided into intracranial and extracranial segments. The intracranial vessels were 42 and the extracranial 68 . Stent insertion points are the “responsible” blood vessels that cause the ischemic event. The technical operation, postoperative complications and short-term follow-up (mean 21 ± 10.3 months) of the two groups were statistically analyzed. Results All 68 cases of extracranial technique were successfully operated. The intraoperative complications were found in 10 cases. The short-term heart rate and blood pressure were decreased in the open carotid artery stenting. In the intracranial 42 cases, 39 cases were successful in operation, 1 case had intracerebral hemorrhage (death), 3 cases had stent thrombosis, and 2 cases had vasospasm. Conclusions Intracranial stenting is difficult to manipulate and has some risks. It should be carefully implemented. Intracranial stenting has a higher operability, higher success rate and lower risk. The benefits Bigger