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动脉粥样硬化性颅内动脉狭窄的支架成形
大纲
颅内血管的特点
TIA的病理生理
进展
治疗
有待探讨的问题
颅内血管的特点
血管与其相应供血区的关系
血管壁的结构
穿支的问题
血管走行特点
TIA的病理生理
大动脉狭窄型
栓塞型
腔隙型
混合型
进展
自然病程
药物治疗
WASID
支架治疗
首例
目前报道的小结
进展
第一例颅内动脉支架(1996年7月)
Cathet Cardiovasc Diagn. 1996 Jul;38(3):316-9
Use of coronary Palmaz-Schatz stent in the percutaneous treatment of an intracranial carotid artery stenosisFeldman RL, Trigg L, Gaudier J, Galat J.Ocala Heart Institute, Florida, USA.
A 69-yr-old man had chronic transient ischemia attacks due to severe stenosis of the intracranial portion of the right carotid artery. After failure of both antiplatelet and anticoagulant therapy, treatment was essful with percutaneous transluminal angioplasty and a coronary Palmaz-Schatz stent. Use of the stent led to a better angiographic result than angioplasty alone. The patient is asymptomatic 4 mo later.
进展
进展
SSYLVIA Trial
WINGSPAN Trial (prospective, multicenter study )
selfexpanding microstent
45 patients with stenoses > 50%
ipsilateral stroke or death rate of
30-d %
6-m %
进展
多中心、随机对照研究