摘要：

目的 探讨单纯球囊扩张术治疗症状性颅内动脉狭窄围手术期疗效及安全性。方法 回顾分析 2016 年 5 月至 2019 年 5 月采用单纯球囊扩张术治疗的 28 例症状性颅内动脉重度狭窄患者的临床、实验室、影像学及随访资料，并评价术后手术成功率、术后并发症、改良 Rankin 量表（mRS）评分和随访情况。结果 28 例患者中共有 26 例成功完成球囊扩张术，手术成功率为 92.86%，术后即刻狭窄远端改良脑梗死溶栓血流分级均 ≥ 2b 级；另外 2 例应用支架成形术。28 例患者术后及随访 30 d 均未出现临床症状加重的相关并发症。术后 30 d 10 例患者 mRS 评分为 1 分，其余 18 例患者 mRS 评分为 0 分。结论 单纯球囊扩张术治疗症状性颅内动脉狭窄围手术期相对安全，支架成形术是球囊扩张术效果欠佳时的一种方法。

关键词: 颅内动脉疾病, 动脉粥样硬化, 血管成形术, 气囊

Abstract:

Objective A recent randomized controlled trial suggested that aggressive medical management was superior to angioplasty for symptomatic intracranial artery stenosis. But it still had its flaws. This study investigated the perioperative safety of balloon angioplasty for symptomatic intracranial artery stenosis. Methods Twenty-eight patients with severe symptomatic intracranial artery stenosis were treated by balloon dilatation alone from May 2016 to May 2019. The success rate, complications, modified Rankin scale (mRS) and follow-up data were evaluated. Results Twenty-six of 28 patients underwent balloon angioplasty successfully with a success rate of 92.86%. Immediate distal stenosis perfusion was more than Modified Thrombdysis in Cerebral Infarction (mTICI) grade 2b. Stent-assisted angioplasty was used in the other 2 cases. No complications related to worsening clinical symptoms occurred in 28 patients after operation and 30 d of follow-up. There were 10 patients whose modified Rankin Scale (mRS) score was 1 on the 30th day after operation, and the other 18 patients' mRS score was 0. Conclusions Balloon angioplasty is relatively safe in the perioperative period of symptomatic intracranial artery stenosis. Stent-assisted angioplasty is a technique used when balloon angioplasty is ineffective.

Key words: Intracranial arterial diseases, Atherosclerosis, Angioplasty, balloon