中国脑血管病杂志2017，Vol.14Issue(6)：326-331,6.DOI:10.3969/j.issn.1672-5921.2017.06.009
复杂症状性大脑中动脉狭窄Solitaire支架置入术后疗效及血流动力学分析
Efficacy and hemodynamic analysis of complex symptomatic middle cerebral artery stenosis after Solitaire stent implantation
摘要
Abstract
Objective To analyze the efficacy and hemodynamic changes in patients with complex symptomatic middle cerebral artery stenosis after Solitaire AB stent implantation.Methods From June 2013 to June 2016,7 consecutive patients with complex symptomatic middle cerebral artery stenosis treated with Solitaire stents at the Department of Neurology,the Third People's Hospital of Hubei Province were enrolled retrospectively.The stenosis rate ≥70% was confirmed by digital subtraction angiography (DSA).Of the 7 patients,5 were male and 2 were female,with an average age of 70±8 years.The general data of the patients were documented,including clinical symptoms,modified Rankin scale(mRS)score,stenosis degree,vascular pathways LMA classification and Mori typing for stenosis,and postoperative residual stenosis or restenosis.The hemodynamic parameters at day 1,7,and 3 months before and after procedure were compared.Results All patients were successfully implanted with the Solitaire AB stents.(1) Of the 7 patients,the Mori type A of stenosis lesions was in 4 cases,B in 2 cases,and C in 1 case.The LMA typing of vascular approaches were Type Ⅲ in 3 cases,type Ⅱ in 4 cases.The preoperative stenosis rate was 80±7%,the residual stenosis rate was 24±13%,and there were no operation-related complications.No ischemic events occurred during the follow-up period.(2) Before stent implantation and at 1 d,7 d,and 3 months after procedure,the peak systolic velocity (PSV) were 297±41,144±34,145±27,and 143±40 cm/s,respectively,the end diastolic velocity (EDV) were 159±22,68±16,68±14,and 66±17 cm/s,respectively,and the pulse index (PI) were 0.67±0.06,0.80±0.08,0.80±0.07,and 0.82±0.06,respectively.PSV,EDV,and PI at 1 d,7 d,and 3 months were improved compared with before procedure (all P<0.05),There were no significant differences at all time points in the pairwise comparison PSV and EDV and PI at all time points after the procedure (all P>0.05).Conclusions Initial analysis showed that no procedure-related complications were observed in the treatment of vascular tortuosity and complex middle cerebral artery stenosis with the Solitaire stents.The short-term curative effect is exact;However,it still needs to be validated further.关键词
颅内动脉硬化/血管成形术/血流动力学/症状性大脑中动脉狭窄/Solitaire支架Key words
Intracranial arteriosclerosis/Angioplasty/Hemodynamics/Symptomatic middle cerebral artery stenosis/Solitaire stents引用本文复制引用
刘文军,邓小容,张红伟,杨昊,张乾,杜敏,彭小祥..复杂症状性大脑中动脉狭窄Solitaire支架置入术后疗效及血流动力学分析[J].中国脑血管病杂志,2017,14(6):326-331,6.基金项目
武汉市临床医学(西医药类)科研项目(WX16C32) （西医药类）
