球囊扩张支架与自膨支架治疗症状性颅内动脉重度狭窄的比较  

Balloon-dilatable Stent and Self-expanding Stent Angioplasty in Treatment of Patients with Severe Symptomatic Intracranial Arterial Stenosis

作　　者：张莉[1] 薛新琴[1] 陈立峰[1] 张云书[1] 赵平平[1] 王军英[1] 王坤[1] 段毅[1] 

机构地区：[1]石家庄市第三医院神经内科,石家庄050000

出　　处：《解放军医药杂志》2017年第6期99-102,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：国家"十二五"科技支撑计划项目(2011BAI08B00);石家庄市科学技术研究与发展指导计划(141462983)

摘　　要：目的探讨球囊扩张支架和自膨支架治疗症状性颅内动脉重度狭窄的围手术期并发症发生率及其差异。方法回顾性分析2010年9月—2016年5月行支架置入术治疗的99例症状性颅内动脉狭窄病历资料,其中96例成功行颅内支架置入术,按支架类型分为球囊扩张支架组46例和自膨支架组50例。观察围手术期脑血管并发症发生情况,比较两组并发症的差异。结果球囊扩张支架组和自膨支架组手术成功率分别为95.8%和98.0%,两组比较差异无统计学意义(P>0.05)。两组围手术期发生并发症共7例(7.3%),其中出血性卒中1例(1.0%),缺血性卒中6例(6.3%)。球囊扩张支架组围手术期发生并发症3例(6.5%),其中出血性卒中1例(2.2%),缺血性卒中2例(4.3%)。自膨支架组围手术期发生并发症4例(8.0%),均为缺血性卒中。两组围手术期总并发症发生率、出血性卒中发生率、缺血性卒中发生率比较差异均无统计学意义(P>0.05)。结论两种类型支架治疗颅内动脉重度狭窄均安全有效,技术成功率和并发症发生率相似。Objective To investigate incidence rate of perioperative complications and differences between bal- loon-dilatable stent and self-expanding stent angioplasty in treatment of patients with severe symptomatic intracranial arte- rial stenosis. Methods Clinical data of 99 patients with symptomatic intracranial arterial stenosis undergoing stent angio- plasty during September 2010 and May 2016 were retrospectively analyzed. Among them, 96 patients successfully under- went intracranial stenting, and were divided into balloon-dilatable stent group （n = 46） and self-expanding stent group （n = 50） according to stent type. Incidence of perioperative eerebrovascular complications was observed, and difference in the complications was compared between the two groups. Results The successful rates of surgical technique were 95.8% in balloon-dilatable stent group and 98.0% in self-expanding stent group respectively, but there was no signifi- cant difference in the rate between two groups （P 〉0. 05）. There were 7 patients （7.3%） with perioperative complica- tions, which included 1 （1.0%） with hemorrhagic stroke and 6 （6.3%） with ischemic stroke, in balloon-dilatable stent group, 3 patients （6.5%） had perioperative complications, which included 1 （2.2%） with hemorrhagic stroke and 2 patients （4.3%） with ischemic stroke. In self-expanding stent group, 4 patients （8.0%） had perioperative complica- tions, and all of them were ischemic stroke. There were no significant differences in incidence rates of total complication, hemorrhagic stroke and ischemic stroke between the two groups （P 〉 0. 05）. Conclusion Both balloon-dilatable stent and self-expanding stent angioplasty are effective and safe in treatment of patients with severe symptomatic intracranial arterial stenosis, and technical success rate and incidence rate of complications are similar.

关 键 词：颅内动脉狭窄 球囊扩张支架 自膨式支架 围手术期并发症 

分 类 号：R743[医药卫生—神经病学与精神病学]