Neuroform EZ支架及Solitaire AB支架在颅内动脉粥样硬化性重度狭窄治疗中的应用  

Application of Neuroform EZ stent and Solitaire AB stent in the treatment of severe intracranial atherosclerotic stenosis

作　　者：张荣举[1] 王君[1] 曹向宇[1] 杜志华[1] 刘新峰[1] 吕斌[1] 王中魁[1] 李宝民[1] 于生元[1] Zhang Rongju;Wang Jun;Cao Xiangyu;Du Zhihua;Liu Xinfeng;Lyu Bin;Wang Zhongkui;Li Baomin;Yu Shengyuan(Department of Neurology,the First Medical Center,PLA General Hospital,Beijing 100853)

机构地区：[1]解放军总医院第一医学中心神经内科,北京100853

出　　处：《中华解剖与临床杂志》2021年第4期391-396,共6页Chinese Journal of Anatomy and Clinics

基　　金：国家自然科学基金(81371296)。

摘　　要：目的:探讨Neuroform EZ支架及Solitaire AB支架治疗症状性颅内动脉粥样硬化性重度狭窄(ICAS)的疗效和安全性。方法:回顾性队列研究。纳入2018年7月—2019年12月解放军总医院第一医学中心神经内科行Neuroform EZ支架或Solitaire AB支架植入治疗的症状性ICAS患者142例,其中男95例、女47例,年龄(57.7±9.7)岁。按应用支架不同分成Neuroform EZ组(EZ组) 91例及Solitaire AB组(AB组)51例。观察两组患者手术时间、手术成功率、责任血管残余狭窄率及围手术期并发症发生情况;术后定期随访,术后3个月采用改良Rankin量表(mRS)评价患者术后神经功能恢复情况,术后6个月行数字减影血管造影(DSA)检查评估支架内再狭窄率。结果:EZ组共植入Neuroform EZ支架91枚,AB组共植入Solitaire AB支架51枚,两组手术成功率均100%。EZ组手术时间(2.4±0.4)h,AB组手术时间(2.5±0.5)h;颅内责任血管狭窄率EZ组从83.8%±10.1%降为21.5%±12.0%,AB组从85.6%±6.2%降为19.2%±4.6%。两组患者手术时间和责任血管残余狭窄率比较,差异均无统计学意义( P值均>0.05)。术后EZ组发生穿支梗死事件3例、颅内出血1例,AB组发生穿支梗死事件2例,两组均未发生高灌注综合征;围手术期并发症发生率EZ组为4.4%(4/91)、AB组为3.9%(2/51),差异无统计学意义( P>0.05)。EZ组51例患者(51枚支架)获随访,随访时间6~13(8.27±3.18)个月;AB组28例患者(28枚支架)获随访,随访时间6~14(8.61±4.38)个月。术后3个月mRS评分显示两组患者预后均良好:EZ组mRS评分(1.3±0.4)分,AB组mRS评分(1.4±0.2)分,两组比较差异无统计学意义( P>0.05)。术后6个月行DSA检查,支架内再狭窄率EZ组15.7(8/51),AB组14.3%(4/28),两组比较差异无统计学意义( P>0.05)。 结论:Neuroform EZ支架及Solitaire AB支架是症状性ICAS安全、有效的治疗方式。Objective This study aimed to evaluate the safety and efficacy of Neuroform EZ stent and Solitaire AB stent in the treatment of severe symptomatic intracranial atherosclerotic stenosis(ICAS).Methods The clinical data of 142 patients(47 females,95 males;[57.7±9.7]years old)with symptomatic ICAS treated by Neuroform EZ stent and Solitaire AB stent implantation in the First Medical Center of PLA General Hospital from July 2018 to December 2019 were retrospectively analyzed.The patients were divided into the Neuroform EZ group(EZ group,91 cases)and the Solitaire AB group(AB group,51 cases).Operation time,success rate,residual stenosis rate,and perioperative complications were analyzed.The patients were regularly followed up,and the modified Rankin score(mRS)was used to evaluate the recovery of neurological functions 3 months after the operation.Digital subtraction angiography(DSA)was performed to evaluate the rate of in-stent restenosis 6 months after the operation.Results A total of 91 Neuroform EZ stents and 51 Solitaire AB stents were implanted in the EZ group and the AB group,respectively.The success rate of operation in both groups was 100%.Operation time was(2.4±0.4)h in the EZ group and(2.5±0.5)h in the AB group.The rate of stenosis in the EZ group was reduced from 83.8%±10.1%to 21.5%±12.0%and that in the AB group was reduced from 85.6%±6.2%to 19.2%±4.6%.The difference in operation time and residual stenosis rate between the two groups was not significant(all P values>0.05).The EZ group had three cases of perforator infarction and one case of intracranial hemorrhage.The AB group had two cases of perforator infarction.No hyperperfusion syndrome occurred in the two group.The incidence of postoperative complications was 4.4%(4/91)in the EZ group and 3.9%(2/51)in the AB group,and the difference was not statistically significant(P>0.05).Fifty-one patients(51 stents)in the EZ group were followed up for 6-13 months(8.27±3.18),whereas 28 patients(28 stents)in the AB group were followed up for 6-14 months(8.61�

关 键 词：动脉粥样硬化 颅内动脉硬化 颅内动脉粥样硬化性重度狭窄 Neuroform EZ支架 Solitaire AB支架 疗效 

分 类 号：R743.3[医药卫生—神经病学与精神病学]