基底动脉狭窄支架成形术的临床研究  

Clinical study of Wingspan stents for symptomatic atherosclerotic stenosis of the basilar artery

作　　者：柴源[1] 柴丽丽[2] 张涛[1] 陈虎[1] 李昕宇[1] 马炜[1] 井丽丽[3] 邓剑平[1] 赵振伟[1] 高国栋[1] 

机构地区：[1]第四军医大学唐都医院神经外科,陕西西安710038 [2]西安交通大学附属西安市中心医院病理科 [3]大庆油田总医院集团让北医院老年病科

出　　处：《实用放射学杂志》2014年第6期1003-1006,1025,共5页Journal of Practical Radiology

摘　　要：目的：评价症状性基底动脉狭窄患者 Wingspan 支架置入术的可行性及有效性。方法回顾性分析 Wingspan 支架治疗症状性基底动脉狭窄患者40例的临床资料,统计支架置入的手术成功率、狭窄率、围手术期并发症。结果手术成功率95.35%,围手术期（术后30 d）并发症发生率20.0%（共8例）,其中2例无后遗症,致死致残性患者6例,死残率15%。36例患者进行了临床随访,平均随访日期为36.3个月（12-75个月）,随访率92.3%。17例患者接受了影像学（DSA 或 CTA）随访,平均随访日期为9.4个月（4-41个月）,2例患者出现症状性支架内再狭窄,再狭窄率为11.76%。在12个月随访期间共发生3例缺血性事件,年不良事件发生率8.33%。结论症状性基底动脉狭窄患者行 Wingspan 支架成形术是可行的、有效的,需慎重把握手术适应证。Objective To assess the efficacy and feasibility of Wingspan stents for symptomatic atherosclerotic stenosis of the basilar artery.Methods Clinical data of 40 patients with symptomatic atherosclerotic stenoses in the basilar artery were analyzed retrospectively.The operative successful rate,the degree of stenosis,perioperative complications and the results of clinical and imaging follow-up were analyzed.Results The technical success rate was 95.35%.The rate of procedure-related complications during the perioperative period （30 days）was 20.0% （eight of 40 patients）.There were two patients with no permanent neurological sequelae. Ipsilateral stroke or death occurred in six patients（1 5%）.Thirty-six patients（92.3%）were available for a clinical follow up.The mean follow-up period was 36.3 months （range 12-75 months）.Seventeen patients （47.2%）were available for follow-up imaging with DSA or CTA.The mean imaging follow-up period was 9.4 months （range 4-41 months）.Symptomatic in-stent restenosis （ISR）was documented in two （1 1.76%）of these patients.Three ischemic events occurred during the follow-up period in 12 months.The adverse event rate was 8.33% at 1 year.Conclusion Wingspan stents for symptomatic atherosclerotic stenosis of the basilar artery was an effective and feasible technique,but we should carefully grasp the operation indications.

关 键 词：WINGSPAN 支架 症状性基底动脉狭窄 支架置入术 围手术期并发症 

分 类 号：R815[医药卫生—放射医学] R743[医药卫生—临床医学]