大脑中动脉狭窄支架成形术的应用

大脑中动脉狭窄支架成形术的应用 2007???G5???G3?E 10 ?b?,?m???M?????R???%???R?????Y ???????m?i?8?u?????n???g?????? ???3???????Q?-?????J?????,?-???????????9?Z?0?2?????e???]442000 ?????????????b?,?m???M(MCA)?????R???]???%???R???????b?????;????26???????????????????8?K???;?? ?????b?,?w?]?????a?M?8?K?b?,?m???M???]?w?w?]?B???????????3???,?]???n???????????b?,?m???M?????8?????R ???]???%???R?????????????]???:???Z?%???????n?R???R?8?????A???1?I?w78.46.2%??(13.44.5)%, ?]?M?????????:?.??30%,?????b?,?w?]?????????:???Z???P?,???????3???????Z?8?K?W???????R???]???%???R?R ?????b?,?m???M???????????????M?;??????????,?????E???;????,???E???;?M????????????. ???L???b?,?m???M?????R???]???%???R TheTherapeuticsofEndovascularStentingAngioplastyforStenosisofMiddleCerebralArtery YUEXuanye,XIGangming,LIURuihua,ZHANGYingchun,QINBiyong(DepartmentofNeurology,PeoplesHospital ofYunyangMedicalCollege,Shiyan,442000,China) AbstractObjectiveTovaluetheeffectandsafetyoftheendovascularstentingangioplastyforstenosis ofmiddlecerebralartery.MethodsWeperformedpercutaneousendovascularstentassistedangioplastyin26 patientswithhigh-gradestenosisofMCAdiagnosisedbyangiography,whohadeitherrecurr enttransient ischemicattacks(TIAs)resistanttomedicaltherapyorseverepersistentischemicofMCA.ResultsStent placementandangioplastyweresuccessfullyperformedinallpatients.Themeandegreeofstenosisreduced from78.46.2%to(13.44.5)%,andthedegreeofresidualstenosiswerelessthan30%.Noneofthepatients developedTIAs,andtheneurologicdeficitwithischemicstrokewereimproved.ConclusionEndovascular stentingforMCAstenosisseemstobeasafeandeffectivetheraputicmethod.Furtherstudyisneededfor longtermoutcome. KeywordsMiddleCerebralArtery,Stenosis,Stenting,Angioplasty ?b?,?m???M(MCA)?????????3???E?,???m?? ?????????????????]???%???RPTA?????%?? ?????Y??MCA?????????????8?K???????m???? ?E???z???Y???E?W?/???M?S?]???B???????W ?b???U?????? 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CT?X???????]??1???,???????3?B??CT?K?w?? ?????,?????????A?????]???????8???6???j ?R?8?]?M?????b?,?w?]?????3?X???????2???b 2007???G5???G3?E 12 ?????????w?????3???]?????R???]???%???8???? ?:???Z???W??????????????NIHSS???1?)?? ?????????M?K???b???0?1?I?w12.62.4 3.82.1 3???? ?b?,?m???M?????????3???E?,???m?????? ?????????????????j?Y?[???W???R?d?k???? ?]?.???????Y???]???????N?????O???????%?? ?????3?-???R?N???]?.???????]?h???%?8 ?3?-???R?N???]???????????????R?y???E???Z ???????6?????????????]???%???R(PTA)?? ???b?,?m???M?????????????z?h???????M?W?/ ?S?)?????]???g?b???????m???????)?e???E ?????????????]????????PTA?8???????????? 50% [2] ???)???P?????????Y?]?????R?????? ???????Y???a???]?????a?????M???????m?? ???w?????????]???????E???i?b?????N?????M ?W?/?????g?b??????????Lee???e?????8,?] ?????R???6???R?????????b?b?,?m???M?????? ?E?M?;???W???,???]???????????????????w?? ???? [3] ?H???w?]?b?,?]???????3?j?M?g???????M?? ?a?e???????M???j?????????)?R???i?????j ?????????R???R?H?g???j?????? [2] ?Y???2?R ?????H???R???????Y???????r?????j?????? ?r?????A?????6???.???????r???????????r ?????????????-???M?h???R???????????r???? ?5???????)???S?R?????????????????j?????? ?R???????w???R?????E???U?i???R?????]?? ???;???M?Y?????b?????R???????R???B?????? ???????M?Y?B???????)???M???w?R?????????r ???????????????Y???r???????????????E???R ?????????w90cm???????????w?????r?????? ?R?????,?????????R?Y8F???r??????????6F ???r?????????r???????R?????w???r?????? ?R?????????o?????M???E???j?Z?b?1?R??M3 ?????R?????????????R???R???i???R???? ???2???????????????????2?R?????????????n ?????????n?????P???K?????R?????????)?? ?R???h???i???R?????????1???o???????????R ???B???i?? [4] ?????g???????????3???;???7 ???????%???????R???%???R ?H???b?,?m???MM1???????z?????M?????i ???.???R???M?1???C?R???6???8?????i?n?%?? ???]???????????)?????,???????E?g?????8 ???H?????????Y???7?????n?R???????k?????b ?a???R???????o?????????????b?????????R?] ?????o?2???????????]?????????????zJiang ???i???B???e???????Y???????M?R???6?????? ?R?E?????]???B?????????????????????????? ?R?]?????????E???w3.0%?b???1?Y?R?m???? ?????????Z?????z???????3???8???? [5] ?w???????R?????K?????]?????????S???N?? ?]???B???,???M?Y?8?????5???j?]???b?.?a?? ?.???R???????]???g???????3?7???R???i?? ?????????;?Y?.???]?????????7???????G?? ???????3?Y???b?,?m???MM1???7???????????? ?????????]?????????????w?????w?;?? snowplowingeffect?]?????????R???3?X ?????????????w???????????Y???R???]???%?? ?R???F???6???7???????K???R???8???d?b???n ?7???%?????????6?7?????n?]?y?????????7 ?????n?????Y???????h???~?????????? [6] ???w ?????????.??1cm?]?????8?K?????????S?? ?]?????2???j?????Y2.5mm???C??MCA?????? ?0?(???R???%???R?H???G?????3?????:?YM1 ???????]???????e?????S???]?????8?K?R?? ?]???????Y3~8mm?????????m?R?????U?Z???? ???????~???R?%?????? ???7???L 1MoriT,FukuokaM,KazitaK,etal.Follow-upstudy afterintracranialpercutaneoustransluminal cerebralballoonangioplasty.AmJ Neuroradiol,1999,20:971-973 2LeeJH,KwonSU,LeeJH,etal.Percutaneous transluminalangioplastyforsymptomaticmiddle cerebralarterystenosis:long-termfollow-up. CerebrovascDis.2003;15(1-2):90-7. 3LeeTH,KimDH,LeeBH,etal.Preliminaryresults ofendovascularstent-assistedangioplastyfor symptomaticmiddlecerebralarterystenosis. AJNRAmJNeuroradiol.2005;26(1):166-74. 4??????,?u???,,?X??,??.???????M?????]?????R???6 ???????;?1??,?????K?5???/??,2003,12:186-188 5JiangWJ,SrivastavaT,GaoF,etal..Perforator strokeafterelectivestentingofsymptomatic intracranialstenosis.Neurology2006; 66:1868-1872. 6??????,?u???,,?X??,??,?]?????R???%???R???????? ?b?b?,?m???M????,?????K?5??,2003,12:193-195