RESUMO
Objective To discuss the operative methods,clinical effect and safety of endovascular stenting in treatment of upra-arch extra intracranial artery stenosis.Methods Symptomatic carotid artery stenosis ＞ 50％,or no symptomatic stenosis ＞ 75％ with upra-arch extra intracranial artery stenosis patients were treated by endovascular stenting,of all patients,85 cases with carotid artery stenosis,37 cases with vertebral artery stenosis,6 cases with subclavian artery stenosis.Results One hundred and twenty-eight patients were treated with 130 vessel,used 131 stents,59 patients used vascular protection,the achievement rate of stent implantation was 100.00％.The degree of stenosis were significantly improved,the degree of stenosis from (87.65 ± 8.70)％ to (14.28 ± 4.87)％.Twenty-six patients appeared transient decline in blood pressure and heart rate,31 patients appeared persistent hypotension and decrease in heart rate.One patient (no using of vascular protection) appeared obhteration in ipsilateral middle cerebral artery,the artery was recanalization after thrombolysis treatment.The rest of 127 patients did not appear intraoperative vascular embolization complications.Eighteen patients appeared perioperative perfusion in transition,1 case happened cerebral hemorrhage (＜ 10 ml).Postoperative symptoms were improved significantly.Followed up for 6-36 months,84 patients had not restenosis in stent,1 patient had symptomless restenosis (＜ 50％).In 37 patients with vertebral artery stenosis,3 patients again appeared ischemia symptoms in postoperative 1 year,digital subtraction angiography (DSA) showed restenosis in stent,the patient was again given endovascular stenting,the symptoms disappeared.Conclusion As long as the correct choice of indications and perioperative treatment properly,the endovascular stenting in treatment of upra-arch extra intracranial artery stenosis has good clinical effect and high security.
