【摘要】 目的评价症状性锁骨下动脉狭窄和闭塞介入治疗方法。方法32例锁骨下动脉狭窄和闭塞,其中锁骨下动脉狭窄19例,闭塞13例。27例有上肢缺血,7例伴头部缺血。应用导丝开通,PTA及内支架置入方法进行治疗。结果28例开通成功。术中发生脑梗死1例。单纯PTA治疗3例,1例上肢缺血症状部分好转。24例置入内支架后症状、体征明显改善。18例有锁骨下动脉窃血征象,术后16例消失。27例随访2～80个月,平均(29.5±21.0)个月。术后9个月闭塞2例,1例PTA后再获通畅。术后12个月闭塞1例,改行外科手术治疗。1例大动脉炎于术后9个月死于心功能衰竭。余在随访期内均无症状再发,超声Dopplor检查均通畅。结论介入方法可有效治疗症状性锁骨下动脉狭窄、闭塞。更多还原

【Abstract】 Objective To evaluate the efficacy of the intervention for stenosis/occlusion in subclavian arteries. Methods Thirty two patients (male 21, female 11) with stenosis or occlusion in subclavian arteries aged from 17 to 74 years old (mean 54 years old). There were 19 stenotic lesions and 13 occlusions. Twenty seven patients had symptoms of upper limb ischemia and 7 had head ischemia. The interventional treatment included canalization with guide-wire, balloon angioplasty and stent implantation. Results Twenty eight lesions were canalized successfully with patency after PTA. Brain infarct occurred in one case during the procedure. Among the three patients treated by single PTA, one had partial recovery of upper limb ischemic symptom. Twenty four patients implanted with stents showed obvious recovery. Eighteen patients with subclavian steal sign disappeared in 16 after the procedures. Twenty seven patients were followed-up from 2 months to 80 months (mean 29.5 ± 21.0 months). Re-occlusion occurred in 3 patients,two at the 6th, and one at 12th month. One achieved a good patency after repetition of PTA,one patient with arteritis died of heart failure at the 9th month and one with occlusion at 12th month was further undergone surgery. Other patients were symptom free under follow up and kept vascular patency by Dopplor examination. Conclusion Intervention is an effective therapy for symptomatic stenosis-occlusion of subclavian arteries. (J Intervent Radiol, 2006, 15: 270-273)更多还原