Clinical value of endovascular interventional therapy in extracranial artery dissection
10.3760/cma.j.cn115354-20210630-00412
- VernacularTitle:血管内介入治疗在颅外段动脉夹层中的应用价值研究
- Author:
Sun YU
1
;
Chengcheng SHI
;
Ji MA
;
Ling WANG
;
Quanhui ZHANG
;
Xinwei HAN
;
Tengfei LI
Author Information
1. 郑州大学第一附属医院放射介入科，郑州大学介入治疗研究所，郑州 450052
- Keywords:
Extracranial artery;
Artery dissection;
Endovascular interventional therapy;
Stent
- From:
Chinese Journal of Neuromedicine
2021;20(12):1212-1217
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical significance of different endovascular interventional therapies in extracranial artery dissection and summarize their therapeutic experiences.Methods:Forty-two patients with extracranial artery dissection underwent endovascular interventional therapies in our hospital from August 2016 to January 2021 were chosen. In these 42 patients (26 with simple intravascular dissection and 16 with dissecting aneurysms), the dissection located in carotid C1 or C2 segment was noted in 37 patients and that in vertebral artery V2 segment was noted in 5 patients. According to the nature, location, and scope of lesions, different endovascular interventional therapies (such as overlapping braided vascular stent implantation, flow-diverter stents implantation, intracranial covered stent implantation and embolism of aneurysm) were adopted. DSA results immediately after surgery and DSA follow-up results 6 months after surgery were evaluated, and the occurrence of adverse events during and within 24 h after surgery was observed and recorded.Results:In the 26 patients with simple intravascular dissection, 3 patients showed vascular occlusion by DSA angiography (1 patient accepted sequential stent implantation [2 Neuroform EZ stents] and 2 patients accepted sequential stent implantation [Neuroform EZ+Wallstent stent] after recanalization; in the left 23 patients, 21 received overlapping braided stent implantation (19 patients had 2 Wallstent stents and 2 patients had 2 LVIS stents) and 2 patients had intracranial covered stent implantation (single Willis stents). Among the 16 patients with dissecting aneurysm, overlapping braided stents were implanted (11 patients had 2 Wallstent stents, 4 patients had single flow-diverter stent, and 1 patient had single Willis stent). The stents were successfully placed in all patients intraoperatively. Immediately after surgery, DSA showed that the stents were well attached, and the blood flow of the responsible vessels was unobstructed; no postoperative complications such as bleeding, vascular occlusion or acute thrombosis were noted. After 6 months of follow-up, all patients had smooth blood flow in the diseased vessels, complete aneurysm occlusion, and no obvious stenosis in the stents.Conclusion:Endovascular interventional therapy is safe and effective for extracranial artery dissection; stent placement should be selected according to the characteristics of the dissection.
