Wingspan支架成形术在症状性大脑中动脉狭窄中的应用
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Application of Wingspan Stent Angioplasty in Symptomatic Middle Cerebral Artery Stenosis
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    目的探讨症状性大脑中动脉狭窄Wingspan支架成形术的临床有效性及安全性。方法回顾性分析23例经自膨式Wingspan支架治疗的症状性大脑中动脉急性缺血、药物治疗无效的大脑中动脉M1段狭窄患者和8例具备支架治疗适应证,但因经济困难等原因未行支架治疗而应用药物治疗的大脑中动脉M1段狭窄急性缺血患者的临床资料。支架组患者经过Gateway球囊预扩后,植入Wingspan自膨式支架。药物组应用依达拉奉注射液和丹参针。于术后7、14、21天后分别进行疗效评定,分析两组患者临床疗效。结果治疗后14天、21天的神经功能改善和日常生活活动能力改善两组间有显著性差异。结论采用Wingspan自膨式支架对有症状的M1段狭窄进行成形术,可行、安全、有效性好,近期随访证实疗效确切,能有效改善急性脑梗死的神经功能缺失和日常生活能力,但这是一项高技术性有创治疗,必须严格把握适应证和防止滥用,以保安全。

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    AimTo discuss clinical efficacy and safety of symptomatic middle cerebral artery (MCA) stenosis Wingspan stent placement.MethodsThe retrospective analysis includes 23 cases of symptomatic MCA acute ischemia and medical treatment-failed MCA M1 stenosis receiving self expandable Wingspan stent and 8 clinical cases of MCA M1 stenosis acute ischemia which enjoy stent treatment indications but receive medical treatment instead of stent treatment for economic reasons.Stent group receives Gateway sacculus pre-expansion and then is implanted with self expandable Wingspan stent.Medicine group receives edaravone injection and salvia miltiorrhiza needle and effect evaluation 7, 14 and 21 days after the operation and group’s clinical curative effect is then analyzed.ResultsThere is significant difference between the two groups 14 and 21 days after treatment in improvement of neural function and daily life activities.ConclusionsWingspan self expandable stent placement on symptomatic M1 stenosis is feasible, safe and effective.Recent follow-up visits have confirmed its curative effects in effectively improving neurologic impairment resulting from acute cerebral infarction and daily life ability.But it is a high-technical wounded treatment.Therefore indications must be strictly treated to prevent abuse for sake of security.

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李海军,张晓龙,黄磊,鲁刚,葛亮. Wingspan支架成形术在症状性大脑中动脉狭窄中的应用[J].中国动脉硬化杂志,2012,20(7):635~638.

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  • 收稿日期:2012-01-31
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