【摘要】 目的探讨自发性颅外段颈动脉夹层(e ICD)患者血管内支架植入术治疗的安全性和疗效。方法选取2012年1月—2013年9月经脑血管造影明确诊断的8例症状性自发性e ICD患者,经抗栓治疗无效后行支架植入术。在治疗后对其临床资料进行总结,并进行出院后随访,通过整理得出数据。结果在8例自发性e ICD患者中,所有支架植入手术均获得成功,2例患者在术中应用了保护伞,无并发症发生。术后即刻造影检查,6例e ICD病变处狭窄基本消失。2例患者于术中球囊预扩张后出现血管闭塞,在迅速支架植入后血管恢复通畅,残留10%~20%狭窄,其余6例患者术后半年随访无一例发生支架内再狭窄。结论血管内支架植人术治疗自发性e ICD安全、有效,但应仔细判断狭窄发生的部位,谨慎对狭窄部位预扩张以及应用保护伞。更多还原

【Abstract】 Objective To evaluate the therapeutic safety and efficacy of endovascular stent implantation in treating spontaneous extracranial internal carotid artery dissection. Methods During the period from January 2012 to September 2013, eight patients with angiography- proved symptomatic spontaneous extracranial internal carotid artery dissection were admitted to author’s hospital. All the patients had to receive endovascular stent implantation after they failed to respond to antithrombotic therapy. The clinical data were retrospectively analyzed. Results Endovascular stent implantation was successfully accomplished in all the 8 patients. During the procedure additional protective umbrella was employed in 2cases although no complications occurred. Cerebral angiography performed immediately after the procedure showed that the extracranial internal carotid stenosis caused by the dissection basically disappeared after stenting. Distal arterial occlusion occurred after pre- dilation with balloon in 2 patients, and the blood flow returned to normal after prompt stent implantation, leaving only 10%- 20% residual stenosis. In the remaining other 6 patients, no in- stent restenosis occurred during the follow- up period lasting for half a year.Conclusion For the treatment of spontaneous extracranial internal carotid artery dissection, endovascular stent implantation is safe and effective. Precise judgment of the site of stenosis, careful manipulation of balloon pre- dilation and the use of protective umbrella are the key points to ensure a successful treatment.更多还原