【摘要】 目的 评价血管支架治疗锁骨下动脉狭窄或闭塞的中期临床疗效。方法 经彩超、CTA明确诊断的31例锁骨下动脉狭窄或闭塞患者,其中狭窄18例(19条),闭塞13例(13条)。导丝开通病变血管后置入支架。术后问诊及彩色多普勒超声进行随访。结果 除4例闭塞血管开通失败外,27例共计28条病变动脉共成功置入28枚支架。术后患者症状、体征均明显改善。术前有锁骨下动脉窃血征象14例,术后12例消失。27例随访6～62个月(平均24.0个月±16.5个月)。术后3例患者再狭窄:1例发生于术后9个月,经PTA后随访12个月血管开放良好;1例术后10个月,PTA后随访8个月开放良好;1例术后12个月再狭窄,转为外科搭桥手术。1例大动脉炎术后8个月死于脑出血;1例术后14个月死于脑梗死。余均无症状、体征再发,多普勒超声提示血管通畅。结论 血管支架可安全、有效治疗锁骨下动脉狭窄/闭塞并有良好中期疗效。更多还原

【Abstract】 Objective To evaluate the mid-term efficacy of endovascular stenting for subclavian artery stenosis or occlusion.Methods Thirty-one patients with stenosis or occlusion of subclavian arteries were diagnosed by color Doppler ultrasound(CDU)and CTA.There were 19 stenotic lesions in 19 cases,and 13 occlusions in 13 cases.Endovascular stents were implanted at disordered vessels after guidewire recanalizing obstruction.All stents implanted were followed-up by CDU.Results Four patiens were failed in recanaliztion.28 stents were successfully installed in 27 patients(28 vessels).The symptoms improved in 27 patients with the stenting arteries patency.Twelve of fourteen patients with subclavian steal sign disappeared instantly after procedures.27 patients followed-up for 6 months to 62 months(mean 24.0±16.5 months).Restenosis occurred after operation in 3 patients:1 patient occurred 9 months later,the artery remained patency 12 months after PTA;1 patient occurred 10 months later,the artery remained patency 8 months after PTA;1 patient occurred restenosis 12 months later,and further undergone surgery.One patient with arteritis died of brain hemorrhage at the 8th month after operation.One patient died of cerbral infarction at the 14th month after operation.The other patients were free-symptom during follow-up period and kept vascular patency by Dopplor examination.Conclusion Endovascular stenting is effective and safe in treatment of subclavian artery stenosis or occlusion and has a better mid-term effect.更多还原