摘要： 研究背景 锁骨下动脉狭窄主要临床表现为锁骨下动脉盗血综合征，血管内支架成形术为其主要治疗方法，本文旨在探讨症状性锁骨下动脉重度狭窄血管内支架成形术的疗效和安全性。方法 回顾分析2012年6 - 11月经血管内支架成形术治疗20例症状性锁骨下动脉重度狭窄患者的临床资料。结果 所有患者支架植入均获成功，术后全脑血管造影提示锁骨下动脉残余狭窄率＜20% ，椎动脉呈顺向血流，锁骨下动脉盗血现象完全消失，同侧椎动脉颅内段血流通畅，临床症状改善；术后无一例出现支架相关性手术并发症。术后10天至6 个月时，血管超声及CTA 检查未见支架内再狭窄，血管形态良好、血流通畅。结论 血管内支架成形术治疗症状性锁骨下动脉重度狭窄是一种微创、安全、有效的治疗方法。

关键词: 血管成形术, 动脉闭塞性疾病, 支架, 锁骨下动脉

Abstract: Background  The major clinical presentation of severe subclavian artery stenosis is subclavian steal syndrome (SSS). At present, stent implantation has become a promising method for this disease. The aim of this article is to investigate the effectiveness and safeness of stent implantation in the treatment for symptomatic severe subclavian artery stenosis. Methods  Clinical data of 20 patients with symptomatic severe subclavian artery stenosis treated via angioplasty and stenting from June 2012 to November 2012 were retrospectively analyzed. Results  The procedure was technically successful in all of the 20 cases. Postoperative digital subtraction angiography (DSA) suggested the residual ratio of subclavian artery stenosis was < 20%. Straight-forward blood flow in vertebral artery, disappeared subclavian steal symptom and fluent blood flow in intracranial segment of ipsilateral vertebral artery were also seen. After procedure no stent-related complications were found. During the follow-up study from 10 days to 6 months, vessel ultrasound and computed tomography angiography (CTA) showed no in-stent restenosis, vessels with good form and fluent blood flow. Conclusion  Percutaneous angioplasty and stenting is a minimally invasive, safe and effective method in the treatment for severe subclavian artery stenosis.

Key words: Angioplasty, Arterialocclusive diseases, Stents, Subclavian artery