ステントによる血管形成術を施行した頭蓋内椎骨・脳底動脈狭窄症の3例

Angioplasty with Stenting for Intracranial Vertebral and Basilar Artery Stenosis : Three Technical Case Reports and Literature Review

I．はじめに

　椎骨脳底動脈狭窄症に対しては，抗血小板剤などによる内科的治療が一般的である．血管吻合術などの外科的治療も行われているが，手技が困難であり，合併症の危険性のわりにその効果は十分ではないとの報告もある．また，症候性脳底動脈狭窄症の内科的治療群での再発率は年間10％前後と高く，その症状は重篤で，死亡例も少なくない，われわれは，頭蓋内・椎骨脳底動脈狭窄症に対しステントによる血管形成術を施行した3例を経験したので報告する．

Patients with intracranial vertebral artery (VA) or basilar artery (BA) stenosis have been mainly treatedwith medication. However, it has been reported that about 10% of patients experience restroke in the VBAterritory, with a high rate of morbidity and mortality. Percutaneous transluminal angioplasty (PTA) is re-garded as one of the treatments although it carries the risk of restenosis, recoil or dissection. Stent place-ment is, therefore, considered to be a further option for the treatment of intracranial artery stenosis since itcan prevent the restenosis.

We report three medical refractory cases of intracranial VA (2 cases) or BA stenosis (1 case) treatedwith stenting, none of which had complications and their symptoms disappeared or diminished.

Angioplasty with the use of a stent device is regarded as a useful treatment for intracranial artery steno-sis, but its risk and long-term result need to be investigated further.