不同类型支架治疗椎动脉开口狭窄的对照研究  

The effect and safety of different types of stents in treating vertebral artery origin stenosis:a control study

作　　者：夏金超 汪勇锋 许岗勤 薛降宇 白卫星 朱良付 王子亮 XIA Jinchao;WANG Yongfeng;XU Gangqin;XUE Jiangyu;BAI Weixing;ZHU Liangfu;WANG Ziliang(Department of Cerebrovascular Diseases,Henan Provincial People's Hospital,People's Hospital of Zhengzhou University,Zhengzhou,Henan Province 450003,China)

机构地区：[1]河南省人民医院(郑州大学人民医院)脑血管病科,郑州450003

出　　处：《介入放射学杂志》2020年第2期136-139,共4页Journal of Interventional Radiology

摘　　要：目的比较不同类型支架治疗椎动脉开口狭窄的有效性和安全性。方法2018年1月至2018年12月73例椎动脉开口狭窄患者共86条病变血管接受支架成形术治疗,分别应用肾动脉支架23枚,Apollo支架26枚,冠状动脉裸支架19枚,药物洗脱支架(DES)18枚。回顾性分析患者临床资料,对比不同类型支架植入术疗效和支架内再狭窄发生率。结果不同类型椎动脉开口支架成形术均获成功。术前影像显示椎动脉开口平均狭窄率为90.9%,术后即刻影像显示平均残余狭窄率为10.3%。围术期手术相关并发症发生率为1.2%(1/86)。术后平均随访(6.2±3.1)个月,患者临床症状得到改善。肾动脉枚架失访1枚,再发狭窄4枚(17%);Apollo枚架失访2枚,再发狭窄8枚(31%),1例患者术后第2日并发大面积后循环脑梗死;冠状动脉裸枚架无失访,再狭窄7枚(37%),1例患者6个月时枚架断裂;DES组失访1枚,再狭窄2枚(11%),与其他组再发狭窄差异有统计学意义(P<0.05)。结论不同类型枚架治疗椎动脉狭窄安全有效。DES在降低枚架内再狭窄发生方面最优,肾动脉枚架次之,Apollo枚架和冠状动脉裸枚架再狭窄率较高。Objective To compare the effectiveness and safety of different types of stents in treating vertebral artery origin stenosis.Methods A total of 73 patients with vertebral artery origin stenosis(86 affected arteries in total),who were admitted to authors’hospital during the period from January 2018 to December 2018 to receive stent angioplasty,were enrolled in this study.For the 86 affected arteries,renal artery stent(n=23),Apollo stent(n=26),bare coronary stent(n=19)and drug-eluting stent(DES,n=18)were separately used.The clinical data were retrospectively analyzed.The curative effect and the incidence of instent re-stenosis were compared between different types of stents.Results Successful stent angioplasty of vertebral artery origin stenosis was accomplished in all patients.Preoperative angiography showed that the average degree of stenosis was 90.9%.Immediate postoperative angiography demonstrated that the average degree of residual stenosis was 10.3%.The incidence of perioperative procedure-related complications was 1.2%(1/86).The patients were followed up for a mean period of(6.2±3.1)months,and the patient’s clinical symptoms were improved.In cases having received renal stent,one case was lost in touch and in-stent restenosis occurred in 4 cases(17%).In cases having received Apollo stent,2 cases were lost in touch,instent re-stenosis occurred in 8 cases(31%),and one case developed massive posterior circulation cerebral infarction at the second day after stent implantation.No one of patients having received bare coronary stent was lost in touch,in-stent re-stenosis occurred in 7 cases(37%)and stent fracture occurred in one case.In cases having received DES,one case was lost in touch and in-stent re-stenosis occurred in 2 cases(11%),the difference in the occurrence of in-stent re-stenosis was not statistically significant when compared with other stents(P<0.05).Conclusion Stent angioplasty,regardless of using renal artery stent,Apollo stent,bare coronary stent or DES,is clinically safe and effective.In red

关 键 词：药物洗脱支架 金属裸支架 椎动脉开口狭窄 再狭窄 

分 类 号：R743[医药卫生—神经病学与精神病学]