Stenting and angioplasty of small cerebral arteries in symptomatic intracranial atherosclerotic disease.
Stenting and angioplasty of small cerebral arteries in symptomatic intracranial atherosclerotic disease.
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有症状的颅内动脉粥样硬化性疾病的小脑动脉支架置入术和血管成形术。
DOI：
10.1159/000357453
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发表时间：
2014
影响因子：
--
通讯作者：
Fitzsimmons,Brian-Fred
中科院分区：
文献类型：
--
作者：
Zaidat,OsamaO;Kalia,Junaid;Nourollah-Zadeh,Emad;Castonguay,Alicia;Lazzaro,Marc;Lynch,John;Fitzsimmons,Brian-Fred
背景颅内动脉粥样硬化性疾病（ICAD）是卒中的常见原因，尽管药物治疗，但其自然病史较差。很少有研究探讨血管内治疗颅内远端动脉症状性ICAD。在这里，我们介绍了球囊血管成形术治疗难治性小动脉症状性ICAD的可行性和安全性。方法回顾个人日志，以确定使用血管成形术和/或支架植入术治疗小动脉ICAD（狭窄率为50%）的患者。脑小动脉定义为直径≤2mm或颅内大血管远端的任何分支（即内颈动脉、M1、A1或椎基底动脉干远端）。收集并分析患者特征、临床表现、治疗方法、病程及随访资料。结果原发性球囊血管成形术（58.3%）和血管支架成形术（41.6%）12例，技术成功率均为100%。治疗前平均狭窄率为79.9%，治疗后平均狭窄率为19.0%。无重大围手术期并发症，包括症状性颅内出血或死亡；3例合并腹股沟血肿。患者平均随访18.6个月，仅有1例症状性再狭窄成功消退。随访时，所有患者的功能预后良好，改进的兰金量表为0（80%）或1（20%）。结论在我们的病例系列中，血管成形术和/或支架置入术治疗症状性小动脉ICAD是安全有效的。这些干预措施应被视为对药物治疗难治性ICAD患者的替代治疗。
BackgroundIntracranial atherosclerotic disease (ICAD) is a common cause of stroke with a poor natural history despite medical therapy. Few studies have investigated endovascular therapies for the treatment of symptomatic ICAD in distal intracranial arteries. Here, we present the feasibility and safety of balloon angioplasty with and without stenting in patients with medically refractory small-artery symptomatic ICAD.MethodsPersonal logs were reviewed to identify patients who were treated for small-artery ICAD (stenosis> 50%) using angioplasty and/or stenting. Small cerebral arteries were defined by a diameter of≤ 2 mm or any branch distal to a large intracranial vessel (ie distal to the internal carotid artery, M1, A1, or vertebrobasilar trunk). Patient characteristics, clinical manifestations, treatment, hospital course, and follow-up data were collected and analyzed.ResultsTen patients (12 arteries) were treated with either primary balloon angioplasty (58.3%) or angioplasty with stenting (41.6%) with a 100% technical success rate. Mean pretreatment stenosis was 79.9%, while mean posttreatment stenosis was 19.0%. There were no major periprocedural complications, including symptomatic intracranial hemorrhage or mortality; 3 cases were complicated by groin hematoma. Patients were followed for a mean total of 18.6 months with only 1 symptomatic restenosis which was retreated successfully. All patients had good functional outcome with a modified Rankin Scale of either 0 (80%) or 1 (20%) on follow-up.ConclusionIn our case series, treatment of symptomatic small-artery ICAD with angioplasty and/or stenting was safe and effective. These interventions should be considered as an alternative treatment for ICAD patients refractory to medical therapy.
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腺苷通过与 A2 受体和细胞内位点相互作用来放松主动脉。
影响因子：
5
作者：
M. Collis;C. Brown
通讯作者：
C. Brown
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DOI：
10.1113/jphysiol.1978.sp012446
发表时间：
1978
期刊：
The Journal of Physiology
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--
作者：
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DOI：
10.1152/ajplegacy.1975.229.4.967
发表时间：
1975
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The American journal of physiology
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J. B. Pritchard;N. O'Connor;J. Oliver;R. Berlin
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R. Berlin
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发表时间：
1983
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B. Henon;D. McAfee
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D. McAfee
影响因子：
7.3
作者：
G. A. Bentley
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G. A. Bentley