2026 年第 9 期 第 21 卷

血栓保护联合球囊血流阻断与药物洗脱支架治疗椎动脉起始部狭窄合并血栓形成的临床效果研究

Clinical efficacy of thrombus protection combined with balloon flow occlusion and drug-eluting stent in the treatment of vertebral artery origin stenosis complicated with thrombosis

作者：白杨1邹亮1王玉2

英文作者：Bai Yang1 Zou Liang1 Wang Yu2

单位：1内蒙古林业总医院神经外科，呼伦贝尔022150；2内蒙古林业总医院急诊医学科，呼伦贝尔022150

英文单位：1Department of Neurosurgery Inner Mongolia Forestry General Hospital Hulunbuir 022150 China; 2Department of Emergency Medicine Inner Mongolia Forestry General Hospital Hulunbuir 022150 China

关键词：椎动脉起始部狭窄；血栓保护；球囊血流阻断；药物洗脱支架；血栓形成

英文关键词：Vertebralarteryoriginstenosis;Thrombusprotection;Balloonflowocclusion;Drug-elutingstents;Thrombosis

• 摘要：

• 目的 观察血栓保护联合球囊血流阻断及药物洗脱支架治疗椎动脉起始部狭窄（VAOS）合并血栓形成的效果。方法 收集2023年9月至2025年5月内蒙古林业总医院收治的148例VAOS合并血栓形成患者的临床资料进行回顾性分析。按不同治疗方法分为2组，对照组75例采用球囊血流阻断联合药物洗脱支架治疗，观察组73例在对照组基础上增加血栓保护装置治疗，比较2组治疗效果。结果 术后3个月，2组血管狭窄率、狭窄血管长度低于/短于术前，且观察组低于/短于对照组；2组椎动脉起始段的收缩期峰值血流速度、舒张末期血流速度均低于术前，且观察组均低于对照组；2组美国国立卫生研究院卒中量表评分、改良Rankin量表评分均低于术前，且观察组均低于对照组，差异均有统计学意义（均P＜0.05）。观察组循环卒中事件发生率低于对照组［2.7%（2/73）比12.0%（9/75）］，差异有统计学意义（χ2=4.611，P=0.032）。观察组手术成功率高于对照组、术后1年再狭窄发生率低于对照组［97.3%（71/73）比88.0%（66/75）、6.8%（5/73）比21.3%（16/75）］，差异均有统计学意义（均P<0.05）。结论 VAOS合并血栓形成患者采用血栓保护措施联合球囊血流阻断及药物洗脱支架治疗，能够获得较高的手术成功率，降低血管狭窄率和狭窄血管长度，改善血流动力学状况，减轻神经功能损伤程度，再狭窄发生率较低。

• Objective To observe the clinical efficacy of thrombus protection combined with balloon flow occlusion and drug-eluting stent for vertebral artery origin stenosis (VAOS) complicated with thrombosis. Methods Clinical data of 148 patients diagnosed with VAOS combined with thrombosis admitted to Inner Mongolia Forestry General Hospital from September 2023 to May 2025 were retrospectively analyzed. All patients were divided into two groups according to different treatment regimens. The control group (75 cases) received balloon flow occlusion combined with drug-eluting stent implantation, while the observation group (73 cases) was treated with additional thrombus protection device on the basis of the control group. The therapeutic outcomes were compared between the two groups. Results At 3 months after operation, the vascular stenosis rate and stenotic vessel length of both groups were decreased and shortened compared with baseline, with lower stenosis rate and shorter stenotic segment in the observation group. The peak systolic flow velocity and end-diastolic flow velocity of vertebral artery origin in two groups were lower than those before surgery, and the values in the observation group were significantly lower. The scores of national institutes of health stroke scale and modified Rankin scale in both groups declined after treatment, and the observation group presented lower scores (all P＜0.05). The incidence of recurrent stroke events in the observation group was lower than that in the control group ［2.7%(2/73) vs 12.0%(9/75)］(χ2=4.611, P=0.032). The operation success rate was higher and the 1-year postoperative restenosis rate was lower in the observation group compared with the control group ［97.3%(71/73) vs 88.0%(66/75); 6.8%(5/73) vs 21.3%(16/75)］(both P<0.05). Conclusions For patients with VAOS combined with thrombosis, the combination therapy of thrombus protection, balloon flow occlusion and drug-eluting stent can achieve high surgical success rate, reduce vascular stenosis rate and stenotic vessel length, improve hemodynamic status, alleviate neurological impairment, and lower the incidence of restenosis.