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1、动脉粥样硬化性颅内动脉狭窄的支架成形大纲颅内血管的特点TIA的病理生理进展治疗有待探讨的问题颅内血管的特点血管与其相应供血区的关系血管壁的结构穿支的问题血管走行特点TIA的病理生理大动脉狭窄型栓塞型腔隙型混合型进展自然病程药物治疗WASID支架治疗首例目前报道的小结进展第一例颅内动脉支架（1996年7月）CathetCardiovascDiagn.1996Jul;38(3):316-9UseofcoronaryPalmaz-Schatzstentinthepercutaneoustreatmentofanintracranialca
2、rotidarterystenosisFeldmanRL,TriggL,GaudierJ,GalatJ. OcalaHeartInstitute,Florida,USA.A69-yr-oldmanhadchronictransientischemiaattacksduetoseverestenosisoftheintracranialportionoftherightcarotidartery.Afterfailureofbothantiplateletandanticoagulanttherapy,treatmentwassuc
3、cessfulwithpercutaneoustransluminalangioplastyandacoronaryPalmaz-Schatzstent.Useofthestentledtoabetterangiographicresultthanangioplastyalone.Thepatientisasymptomatic4molater.进展进展SSYLVIATrialWINGSPANTrial（prospective,multicenterstudy）selfexpandingmicrostent45patientswit
4、hstenoses>50%ipsilateralstrokeordeathrateof30-d4.4%6-m7.1%进展多中心、随机对照研究进展Astechnologyandexperienceevolve,thisprocedureisbecomingincreasinglyeffectiveandsafeforthetreatmentofintracranialatheroscleroticdisease,andguidelinesarebeingdevelopedforitsuse.HartmannM,etal.CurrOpN
5、eurol.2005;18:39–45.AJNRAmJNeuroradiol.2005;26:2323–2327.进展Withinperi-procedureStrokeanddeath8.3%Annualstroke3%-5%NeurosurgClinNAm.2005;16:297–308.AJNRAmJNeuroradiol.2005;26:525–530.进展Thisprocedure,however,remainshazardouswithupto50%ofpatientsshowingnew,ipsilateralisch
6、emiclesionsondiffusion-weightedMRimages.AJNRAmJNeuroradiol.2005;26:385–389.进展IntracranialangioplastywithorwithoutstentingshouldbeofferedtosymptomaticpatientswithintracranialstenoseswhohavefailedmedicaltherapySimilartorevascularizationforextracranialcarotidarterystenosi
7、s,patientbenefitfromrevascularizationforsymptomaticintracranialarterialstenosisiscriticallydependentonalowperiproceduralstrokeanddeathrateandshouldthusbeperformedbyexperiencedneurointerventionistsJVascIntervRadiol2005;16:1281–1285进展Drug-elutingstents,althoughshowingpro
8、miseincoronaryandcaninevesselsforthepreventionofrestenosis,arestillnotreadyforhumancerebralarteriesbecauseofdiffering
