国产药物洗脱支架(Bridge)在颅内前循环血管狭窄中的应用  

Application of domestic rapamycin eluting stents(Bridgein)in patients with anterior circulation intracranial stenosis

作　　者：杨松 周旭 刘敬禹 王立辉 陈森 聂文 徐增良 纪德峰 宋海涛 YANG Song;ZHOU Xu;LIU Jing-yu;WANG Li-hui;CHEN Sen;NIE Wen;XU Zeng-liang;JI De-feng;SONG Hai-tao(Department of Neurosurgery,Jiaozhou Branch,Dongfang Hospital,Tongji University,Qingdao 266100,China;Department of Intervention,Jiaozhou Branch,Dongfang Hospital,Tongji University,Qingdao 266100,China)

机构地区：[1]同济大学附属东方医院胶州医院神经外科,山东青岛266100 [2]同济大学附属东方医院胶州医院介入科,山东青岛266100

出　　处：《中国临床神经外科杂志》2023年第8期497-499,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨国产雷帕霉素药物洗脱支架(Bridge)在颅内前循环狭窄中的应用效果。方法2022年1月至2022年9月前瞻性收治颅内前循环血管狭窄55例,按入院顺序给予EnterpriseⅡ支架(29例)或雷帕霉素药物洗脱支架(Bridge,26例)治疗。术后6个月DSA随访,评估再狭窄率和脑梗塞(脑血栓形成)等,术后6个月采用改良Rankin量表(mRS)评分评估预后。结果55例手术成功率为100.0%,围手术期未发生颅内出血、支架内血栓形成、动脉夹层等。Enterprise组2例因大脑中动脉M1段狭窄致急性脑栓塞再次介入手术,术后6个月mRs评分4分,其余27例m RS评分0~1分;3例术后发现再狭窄。Bridge组1例双侧支架置入术后2个月出现一侧急性脑栓塞,术后6个月mRS评分5分,其余25例术后6个月mRS评分0分。两组术后并发症发生率、术后6个月mRS评分无统计学差异(P>0.05)。结论Bridge支架在颅内前循环血管狭窄中应用效果良好,但是需要充分评估病人的血管条件,在颈内动脉海绵窦段过度迂曲病人中可能需要使用长鞘及中间导管,增加手术难度与手术时间。Objective To investigate the clinical efficacy of domestic rapamycin drug-eluting stents(Bridge)for patients with anterior circulation intracranial stenosis.Methods Fifty-five patients with anterior circulation intracranial stenosis were prospectively recruited from January 2022 to September 2022.Twenty-nine patients received Enterprise Ⅱ stent implantation(Enterprise group)and 26 patients received rapamycin drug-eluting stent(Bridgein group)implantation according to the order of admission.The rate of restenosis and cerebral infarction were evaluated by DSA follow-up 6 months after the operation.The prognosis was evaluated using the modified Rankin scale(mRS)score 6 months after the operation.Results The success rate of 55 patients was 100.0%.There was no intracranial hemorrhage,stent thrombosis or arterial dissection during the perioperative period.In the Enterprise group,2 patients suffered from acute cerebral embolism due to middle cerebral artery M1 stenosis who received re-intervention treatment and had a mRS sore of 4 at 6 months after the operation,and the other 27 patients had a mRS score of 0~1 at 6 months after the operation;restenosis occurred in 3 patients.In the Bridge group,1 patient had acute cerebral embolism 2 months after bilateral stent implantation and had a mRS score of 5 at 6 months after the surgery,and the other 25 patients had a mRS score of 0 at 6 months after the surgery.Conclusions Bridge stent is effective in the treatment of patients with anterior circulation intracranial stenosis,but the patient's vascular conditions need to be fully evaluated before the operation.Long sheath and intermediate catheter should be used in patients with excessive tortuosity of the cavernous(C4)segment of the internal carotid artery,which may increase the difficulty and time of surgery.

关 键 词：颅内动脉粥样硬化性狭窄 颅内前循环 支架置入术 EnterpriseⅡ支架 Bridge支架 药物洗脱支架 疗效 

分 类 号：R743.9[医药卫生—神经病学与精神病学] R815.2[医药卫生—临床医学]