症状性颅内动脉粥样硬化性狭窄血管支架置入术后再狭窄的研究进展  

Research progress of in-stent restenosis after stent implantation in symptomatic atherosclerotic intracranial stenosis

作　　者：彭玮 罗海彦[1] PENG Wei;LUO Hai-yan(Department of Neurology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing400010,China)

机构地区：[1]重庆医科大学附属第二医院神经内科,重庆400010

出　　处：《中国当代医药》2020年第7期21-24,共4页China Modern Medicine

基　　金：重庆市卫生适宜技术推广项目(2016jstg014)。

摘　　要：缺血性脑卒中指各种原因引起的局部脑组织供血动脉的血流障碍,导致脑组织缺血低氧性变性坏死,同时出现相应的临床神经功能缺失,是人类疾病谱中致残率最高的疾病之一,给患者家庭及整个社会都带来了沉重的负担。在缺血性脑卒中的TOAST病因分型中,颅内大动脉粥样硬化引起的颅内动脉狭窄约占比例17.3%,在该类型中血管内介入治疗得到了广泛应用。随着血管内支架治疗的不断开展,支架内再狭窄(ISR)等远期并发症也越来越受到关注。本文在近年来国内外研究的基础上,对ISR的发生率、发生机制、危险因素、评估方法、应对措施等方面进行综述,以期为颅内不同血管内支架治疗的安全性及有效性提供辅证,并在颅内动脉粥样硬化性缺血性卒中治疗方式的选择及患者围术期和远期管理上提供帮助。Ischemic stroke refers to the disturbance of blood flow in the blood supply artery of the local brain tissue caused by various reasons,which leads to the ischemic hypoxic degeneration and necrosis of the brain tissue.At the same time,the corresponding clinical neurological function loss occurs.It is one of the diseases with the highest disability rate in the human disease spectrum,which brings heavy burden to the patients′family and the whole society.In the TOAST etiology classification of ischemic stroke,the proportion of intracranial artery stenosis caused by large intracranial atherosclerosis is about 17.3%,in which intravascular interventional therapy has been widely used.With the development of stent therapy,long-term complications such as in-stent restenosis(ISR)have attracted more and more attention.On the basis of the research at home and abroad in recent years,this paper reviews the incidence,mechanism,risk factors,assessment methods and Countermeasures of ISR,so as to provide evidence for the safety and effectiveness of different intracranial endovascular stent therapy,and to provide help in the selection of treatment methods of intracranial atherosclerotic ischemic stroke and the perioperative and long-term management of patients.

关 键 词：支架内再狭窄 颅内动脉粥样硬化 缺血性脑卒中 支架置入术 

分 类 号：R651.15[医药卫生—外科学]