介入治疗开通无名动脉闭塞性病变1例

摘要

We have successfully implemented endovascular stenting in a patient with severe innominate artery ( IA) occlusion with aid of carotid filter under the guidance of digital subtraction angiography (DSA).The patient had amaurosis for 1 year and right upper extremity numbness for half a year .He had a history of hyperlipidemia for 1 year and smoking for 30 years.Combined with magnetic resonance angiography ( MRA ) and computed tomographic angiography ( CTA ) examinations , he was diagnosed as severe IA occlusion.After pre-operative assessment , we decided to use the right femoral artery and right brachial artery as double entries .With the help of distal internal carotid artery ( ICA ) filter as cerebral protective umbrella , we successfully performed the endovascular stenting in the innominate artery .Through this case we can learn that the interventional therapy is the first choice for patients with IA occlusive disease due to its safety , effectiveness and high success rate .The proper selection and application of cerebral protective umbrellas ( carotid filter) have great significance in the prevention of cerebral infarction .%北京协和医院血管外科在数字减影血管造影（ DSA）下利用脑保护伞为1例完全无名动脉（ IA）闭塞患者成功实施了血管内支架植入术。患者因发作性黑曚1年、右上肢麻木6个月入院。既往有高脂血症病史1年，吸烟30年。结合磁共振血管成像（ MRA）及CT血管成像（ CTA）检查，该患者被诊断为无名动脉闭塞。经术前充分评估，采取右股动脉及右肱动脉双入路，在右颈内动脉（ ICA）脑保护伞保护下，成功实施了无名动脉血管内支架植入术。本例诊疗过程提示介入治疗是开通无名动脉闭塞性病变的首选方法，成功率高，安全，有效。脑保护伞的正确选择与应用在预防脑梗死方面有较大意义。