活检在中心静脉狭窄支架再狭窄治疗的作用  

Guidance of in-stent biopsy in treatment of in-stent restenosis after stent implantation in patients with central venous stenosis

作　　者：林跃丽[1] 肖煜东[1] 刘穗玲 胡超[1] 马聪[1] 罗建光[1] 朱晖[1] 肖恩华[1] 张子曙[1] LIN Yueli;XIAO Yudong;LIU Suiling;HU Chao;MA Cong;LUO Jianguang;ZHU Hui;XIAO Enhua;ZHANG Zishu(Department of Radiology,the Second Xiangya Hospital of Central South University,Changsha 410011,China)

机构地区：[1]中南大学湘雅二医院放射科,湖南长沙410011

出　　处：《实用放射学杂志》2021年第9期1528-1530,共3页Journal of Practical Radiology

摘　　要：目的探讨支架内活检在中心静脉狭窄患者支架置入术后再狭窄治疗的指导作用.方法回顾性分析5例已接受裸金属支架置入后发生支架内再狭窄的中心静脉狭窄患者进行支架内活检的病例资料,通过病理检查分析再狭窄处的主要成分,根据病理结果进行相应治疗.结果5例患者均成功进行支架内活检,病理结果显示支架内再狭窄的成分均为血栓.所有患者均未发生严重并发症,仅1例患者在手术过程中出现轻度局部出血,不需要额外治疗.5例患者根据病理均采用华法林抗血栓治疗6个月.术后6个月随访,4例患者支架通畅性良好,1例患者狭窄未解除再次行血管成形术.结论支架内活检可安全用于中心静脉狭窄支架置入术后再狭窄患者,中心静脉狭窄支架置入术后支架内再狭窄与血栓形成有关,表明在接受支架置入的中心静脉狭窄患者,有必要进行抗血栓治疗.Objective To explore the guidance of in-stent biopsy in treatment of in-stent restenosis after stent implantation in patients with central venous stenosis.Methods The clinical,pathological and imaging data of 5 central venous stenosis patients with in-stent restenosis after bare metal bracket implantation confirmed by in-stent biopsy and pathology were analyzed retrospectively.Results In-stent biopsy was performed successfully in 5 patients.Pathological findings showed that the restenosis in stent was composed of thrombus.No severe complications occurred in patients,but only 1 patient experienced mild local bleeding during the operation,which did not require additional treatment.All 5 patients were treated with warfarin antithrombotic therapy for 6 months.After 6 months,according to the results of follow-up,4 patients had sound stent patency,while 1 patient was not relieved of stenosis and performed to angioplasty again.Conclusion In-stent biopsy can be safely used in patients with restenosis after stent implantation in central venous stenosis patients.The in-stent restenosis is related to thrombus,which suggests that antithrombotic therapy is necessary for central venous stenosis patients who received stent placement.

关 键 词：中心静脉狭窄 支架内再狭窄 介入治疗 活组织检查 病理学 

分 类 号：R543.6[医药卫生—心血管疾病] R815[医药卫生—内科学]