Abstract: Objective TCD was applied to detect the microemboli signal during the middle cerebral arteryangioplasty and stenting procedure.Methods Eight consecutive patients (3 females and 5 males, average age 45.5±10.5 years old)were selected in the study since Jan 2006 to Dec 2006. The data was recorded and emphasizedduring the four phases as follows: (1) putting guide catheter; (2) sending microwire through thelesion; (3) stenting delivering system span across the lesion; and (4) primary balloon dilatationperiod. TCD was used continually in this stenting implantation period to record the microemboliof middle cerebral arteries simultaneously, also to record the peak systolic velocity before and afterthe stenting.Results There were no complications related to the procedure. The percentage of stenosis was79.4%±7.8% preoperation, and 9.4%±8.2% postoperation. Peak systolic velocity where the stenosislocated was 305.3±61.5cm/s preoperation, 201.1±40.5cm/s immediately postoperation. Highintensitytransient signals indicative of microemboil could be observed in all four phases (3.5±4.2,8.9±7.2, 4.6±5.8 and 14.5±7.0, respectively), but appeared to be more frequent in the phase 4.Conclusion Angioplasty and stenting implantation is a method in the treatment of the middlecerebral artery stenosis, and can improve cerebral blood flow. Although high-intensity transient signalsare observed in these cases, the relationship between high-intensity transient signals and ischemicevents need to be further explored.

Key words: Transcranial Doppler; Middle cerebral artery; Angioplasty; Microemboli

摘要： 目的 应用经颅多普勒超声（TCD）监测大脑中动脉（MCA）近端狭窄支架成形术中的微栓子信号。方法 2006年1～12月成功进行MCA近端狭窄支架成形术的8例（女3例，男5例，平均年龄45.5±10.5岁）。将手术过程分为4个阶段：（1）导引导管置放阶段；（2）微导丝置放阶段；（3）支架输送阶段；（4）球囊扩张阶段。同步记录手术中各阶段TCD监测到的MCA远端微栓子数目,记录支架成形术前和术后即刻狭窄处收缩期峰值血流速度（Vs）。结果 本组病例无手术相关并发症。术前狭窄率为79.4％±7.8％，术后降至9.4％±8.2％，P＜0.01。MCA近端狭窄处Vs术前305.3±61.5 cm/s，术后即刻为201.1±40.5 cm/s，P＜0.01。4个阶段均可监测到微栓子信号，分别为3.5±4.2、8.9±7.2、4.6±5.8及14.5±7.0（P＜0.01），以第4阶段为著。结论 支架成形术可以改善动脉粥样硬化性MCA狭窄，增加狭窄远端脑组织血流供应。术中各个阶段都能监测到微栓子信号，但术中微栓子脱落与术后缺血性卒中事件的相关性有待于进一步研究。

关键词: 经颅多普勒; 大脑中动脉; 支架成形术; 微栓子