Endovascular Treatment for Bow Hunter's Syndrome: Case Report
Endovascular Treatment for Bow Hunter's Syndrome: Case Report
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DOI：
10.1055/s-0029-1239501
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发表时间：
2009-08-01
影响因子：
--
通讯作者：
Date, I.
中科院分区：
文献类型：
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作者：
Sugiu, K.;Agari, T.;Date, I.
简介：弓猎人综合症是一种独特的临床疾病，由头部旋转时椎动脉机械闭塞引起。尽管通常通过直接手术干预进行治疗，但我们报道了使用血管内支架置入术成功治疗对侧椎动脉狭窄的方法。病例描述：一名 56 岁男性因头部向左转而导致反复眩晕和意识丧失。右侧椎体血管造影未见异常，头部处于中立位。然而，当头部向左旋转60度时，右侧椎动脉在C1-2水平完全闭塞。带骨窗的三维血管造影清楚地显示了骨结构对 C1-2 水平的椎动脉压迫。左锁骨下血管造影显示左椎动脉起始部严重狭窄。在局部麻醉下成功进行了左椎动脉血管成形术和支架置入术。患者术后病程平稳，术前症状消失。术后 6 个月，左锁骨下血管造影显示支架置入的左侧椎动脉通畅良好，患者没有出现复发症状。结论：椎动脉支架置入术是治疗对侧椎动脉狭窄的弓猎人综合征的一种有效且微创的选择。
Introduction: Bow hunter's syndrome is a unique clinical entity caused by mechanical occlusion of the vertebral artery on head rotation. Although it is usually treated by direct surgical intervention, we report successful treatment using endovascular stent placement for contralateral vertebral artery stenosis.Case Description: A 56-year-old man presented with repeated vertigo and loss of consciousness caused by turning his head to the left. Right vertebral angiogram showed no abnormalities with the head in the neutral position. However, with the head rotated 60 degrees to the left, the right vertebral artery was completely occluded at the C1-2 level. A three-dimensional angiogram with bone window clearly demonstrated vertebral artery compression at the C1-2 level by the bony structure. The left subclavian angiogram revealed severe stenosis at the origin of the left vertebral artery. Left vertebral artery angioplasty followed by stent placement was successfully performed under local anesthesia. The patient showed an uneventful postoperative course and his preoperative symptoms disappeared. At 6 months postoperatively, a left subclavian angiogram showed good patency of the stented left vertebral artery and the patient showed no recurrent symptoms.Conclusion: Vertebral artery stenting is a useful and less invasive option in the treatment of bow hunter's syndrome in the setting of contralateral vertebral artery stenosis.