关键词: 动脉闭塞性疾病, 血管成形术, 延髓外侧综合征, 穿支动脉闭塞, 椎动脉颅内段, 支架成形术

Abstract: Abstract： Objective To explore the methods to reduce the occlusion of perforating arteries after intracranial stenting of the vertebral artery. Methods Clinical data of 32 cases of Gateway-Wingspan stent implantation for intracranial branch of vertebral artery were retrospectively analyzed. The postoperative stricture and perfusion improvement situation were evaluated, the reason of perforating artery occlusion was analyzed. Results Thirty-two patients were implanted with 33 pieces of Wingspan stent and 1 piece of Apollo bracket. The operation success rate were 100%, and the stenosis rate reduced from (76.6±6.1)% to (27.9±5.2)%. After three months, the transcranial doppler sonography (TCD) and CT angiography were checked, showing no in- stent restenosis in all patients. Two patients occurred the perforating artery occlusion within 24 hours after operation. The possible reason was the change of stability of atherosclerotic plaque at the stenosis and the plaque displacement caused by the mechanical action of the balloon or stent, which may lead to medulla oblongata artery block. After drug and rehabilitation treatment, the symptoms in patients were improved significantly. Conclusion The perforating artery occlusion after stent implantation in intracranial branch of vertebral artery can be prevented by strict evaluation and preoperative preparation, the right selection of intraoperative balloon and stent, which still needs larger sample data to prove.

Key words: arterial occlusive diseases, angioplasty, lateral medullary syndrome, perforating artery occlusion, intracranial branch of vertebral artery, stent angioplasty