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目的研究对严重颅内脑动脉狭窄进行血管内治疗的可行性和安全性。方法34例症状性颅内脑动脉狭窄患者接受了血管内支架成形术。结果本组MoriA型病变29例,B型病变5例;狭窄位于大脑中动脉12例、大脑前动脉1例、颅内颈内动脉1例、颅内椎-基底动脉20例。在内支架成形术后,平均动脉狭窄率从70.9%下降到9.0%(P<0.01)。在围手术期内,除1例(左椎动脉V3段串联病变)发生蛛网膜下腔出血死亡外,余无严重并发症发生。存活的33例平均随访18个月(3～36个月),未发生缺血性神经事件。结论血管内支架成形术是治疗部分严重颅内脑动脉狭窄安全、有效的方法。
Objective To study the feasibility and safety of endovascular treatment of severe intracranial cerebral artery stenosis. Methods 34 patients with symptomatic intracranial cerebral artery stenosis underwent endovascular stenting. Results The group of MoriA type lesions in 29 cases, B type lesions in 5 cases; stenosis in the middle cerebral artery in 12 cases, anterior cerebral artery in 1 case, intracranial internal carotid artery in 1 case, intracranial vertebral - basilar artery in 20 cases. After endovascular stenting, mean arterial stenosis decreased from 70.9% to 9.0% (P <0.01). During the perioperative period, no serious complications occurred except one case of subarachnoid hemorrhage who died of V3-series lesions of the left vertebral artery. The remaining 33 patients were followed up for an average of 18 months (3 to 36 months) without ischemic neurological events. Conclusion Endovascular stenting is a safe and effective method for the treatment of severe intracranial cerebral artery stenosis.