Recently, the number of dizziness patients coming to the Department of Neurology, The First Affiliated Hospital of Tsinghua University has increased. One of the elderly patients had particularly severe dizziness, manifested as paroxysmal rotation of vision or shaking of surrounding objects. feel. In severe cases, it is accompanied by nausea and vomiting, blurred vision, unsteady walking and easy deflection, often due to emotional agitation or dizziness aggravated by sitting or standing, which can be gradually relieved after half an hour. This patient has a history of hypertension for more than 20 years, long-term smoking and drinking, and chronic dizziness in the past two years.
After hospitalization, the patient was almost bedridden due to dizziness, so he perfected the cervical CTA examination, which showed that one vertebral artery had been occluded, the other side had severe stenosis at the origin of the vertebral artery, and there was a severe lack of posterior circulation. The risk of acute cerebral infarction in the brain stem and cerebellum caused by blood.
To avoid cerebral infarction caused by acute occlusion of stenotic blood vessels, which affects the center of life, whole cerebral angiography (DSA) is performed. Angiography confirmed the patient’s right vertebral artery occlusion and severe stenosis at the origin of the left vertebral artery, which was in line with surgical indications. However, the patient was older and had fragile blood vessels, which increased the risk of surgery. The interventional team of the Department of Neurology fully discussed and prepared a detailed plan before implementing vertebral artery stenting for the patient.
During the operation, the 6F guide catheter was firstly delivered to the left subclavian artery near the opening of the vertebral artery through a super-sliding guide wire, and a 200 cm micro-guide wire was passed through the stenotic segment of the left vertebral artery under the guidance of roadmap. It was sent to the V2 segment, and the vertebral artery drug (rapamycin)-coated stent was delivered to the left vertebral artery stenosis segment through the micro-guide wire.
The postoperative angiography showed that the stenosis was significantly improved. The patient could walk the next day. He excitedly told the doctors and nurses that the symptoms of dizziness disappeared, and there was no feeling of “foot on cotton” when walking, and he could see things clearly and walk normally. , I am very grateful to the neurologist for removing his risk of cerebral infarction and saving his life.