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目的探讨血管介入治疗多发性大动脉炎(Takayasu arteritis,TA)所致血管狭窄或闭塞性病变的临床疗效。方法 2003年6月～2011年6月对27例TA经股动脉穿刺选择性血管造影,确定病变部位,明确诊断,并对因大动脉炎引起的锁骨下动脉、颈动脉、肾动脉、腹主动脉病变进行了选择性球囊扩张或支架植入手术。结果 27例施行血管腔内扩张成形术或支架植入术,其中颈总动脉扩张10例,支架2例;锁骨下动脉扩张6例;腹主动脉扩张4例;肾动脉扩张10例,支架4例;无名动脉扩张1例,支架1例;共置入支架7枚。2例颈动脉扩张时因并发症而终止治疗,其余病例病变血管均获得满意的治疗。27例随访5个月～7年,平均4年,其中<12个月6例,1～3年12例,3～5年6例,>5年3例:11例头晕、视觉异常等脑缺血症状改善;12例肾动脉狭窄所致高血压经球囊扩张及支架植入后血压控制正常;2例肾动脉狭窄在球囊扩张后14、18个月再次发生血压增高,造影显示扩张后肾动脉再次狭窄,再次行肾动脉球囊扩张成形术,扩张后高血压恢复正常。结论介入性血管内成形术治疗TA所致血管狭窄或闭塞性病变疗效满意。
Objective To investigate the clinical efficacy of vascular intervention in the treatment of vascular stenosis or occlusive disease caused by Takayasu arteritis (TA). Methods From June 2003 to June 2011, 27 patients underwent selective angiography of femoral artery puncture through TA to confirm the location of the lesion and definite the diagnosis of subclavian artery, carotid artery, renal artery, abdominal aorta Lesions underwent selective balloon dilatation or stent implantation. Results Twenty-seven patients underwent endovascular discectomy or stent implantation, including 10 cases of common carotid artery dilatation, 2 cases of stent, 6 cases of subclavian artery dilatation, 4 cases of abdominal aorta dilation, 10 cases of renal artery dilatation, 4 cases of stent 4 Cases; anonymous artery expansion in 1 case, stent in 1 case; a total of 7 stent placement. 2 cases of carotid artery dilatation due to complications and termination of treatment, the remaining cases of vascular lesions were satisfactory treatment. 27 cases were followed up for 5 months to 7 years with an average of 4 years, of which 6 cases were less than 12 months, 12 cases were 1-3 years, 6 cases were 3-5 years, 3 cases were> 5 years: 11 cases were dizzy and visual abnormalities Ischemic symptoms improved; 12 cases of hypertensive renal artery stenosis caused by balloon dilatation and stent implantation after the normal blood pressure control; 2 cases of renal artery stenosis at 14 and 18 months after balloon dilatation again increased blood pressure, angiography showed dilatation Renal artery stenosis again, again renal artery balloon angioplasty, after the expansion of high blood pressure returned to normal. Conclusion Interventional endovascular angioplasty is effective in treating vascular stenosis or occlusive disease caused by TA.