应用改良预扩张球囊的Wingspan支架成形术治疗颅内动脉狭窄  

Periprocedure observation of Wingspan stenting for symptomatic intracranial atherosclerosis stenosis with different predilation balloons

作　　者：吴立恒[1] 冯广森[2] 李天晓[1] 朱良付[1] 薛降宇[1] 王子亮[1] 白卫星[1] 

机构地区：[1]郑州大学人民医院介入科,450003 [2]郑州大学附属第二医院介入科,450003

出　　处：《中华实验外科杂志》2016年第1期229-231,共3页Chinese Journal of Experimental Surgery

基　　金：国家“十二五”科技支撑计划（2011BA108B04）;

摘　　要：目的探讨使用改良预扩张球囊的Wingspan支架成形术治疗颅内动脉狭窄的可行性、安全性及短期有效性。方法分析因症状性颅内动脉狭窄在我院行Wingspan支架成形术治疗的168例患者，根据使用预扩张球囊的不同分为A组78例（使用冠脉快速交换球囊预扩张）及B组90例（使用标准Gateway球囊预扩张）。结果（1）纳入患者中2例未成功，技术成功率达98．8％，30d内lO例（6．0％）出现脑血管不良事件，其中缺血7例（4．2％）、出血3例（1．8％）、严重并发症3例（1．8％）。（2）A组有5例（6．4％）出现并发症，B组有5例（5．6％）出现并发症，两组并发症发生率差异无统计学意义（P〉0．05）。（3）与B组比较：病变长短方面，A组更多应用于短病变（P〈0．05）；部位上，更多应用于椎动脉（P〈0．05）而较少应用于大脑中动脉（P〉0．05）；路径上，A组更多应用于简单I型路径上（P〈0．05）；但A组（9．0％）比B组（14．5％）残余狭窄更低（P〈0．01），手术时间更短（P〈0．01）。结论颅内动脉狭窄Wingspan支架成形术并发症在可接受范围内；使用改良快速交换预扩张球囊术后即刻残余狭窄更低、手术时间更短，但更适合于简单病变。Objective To assess the safety and effectiveness of Wingspan stenting for symptomatic intracranial atherosclerosis stenosis with different predilation balloons. Methods The 168 patients who had got symptomatic intracranial atherosclerosis stenosis and were treated with Wingspan stents in our hospital were respectively analyzed. The patients were divided into group A （rapid exchange balloon predilation） and group B （ standard gateway - Wingspan）. Results （ 1 ） Two stents failed to arriving the target vessel after predilation and the technical success rate was 98. 8%. 10 （6.0%） adverse cerebral vascular events occurred within 30 days, including 7 （4. 2% ） ischemic events and 3 （ 1.8% ） hemorrhagic events. Serious complications happened in 3 patients （ 1.8% ）. （2） Five complications （6.4%） occurred in group A and 5 complications （5.6%） in group B. The complication rate of two groups had no significant difference （P〉0. 05）. （3） Patients in group A were more likely to have short lesions （P 〈0. 05）, more likely to have vertebral artery lesions （ P 〈 0. 05 ）, less likely to have middle cerebral artery lesions （ P 〉 0.05 ） , more likely to have I accesses （ P 〈 0. 05）, and likely to have lower degree of residual stenosis and likely to have shorter operating time （ P 〈 0. 01 ）. Conclusion The complication rate of Wingspan stenting for patients with severe symptomatic intracranial atherosclerotie stenosis is acceptable. The Wingspan stenting with modified rapid exchange predilation balloon may have lower degree of residual stenosis than standard gateway - Wingspan group. But the modified rapid exehange predilation balloon is more suitable to the simple lesions.

关 键 词：动脉粥样硬化 支架 卒中 并发症 

分 类 号：R743[医药卫生—神经病学与精神病学]