雷帕霉素洗脱椎动脉支架治疗重度椎动脉起始部狭窄的临床效果观察  

Clinical efficacy of rapamycin-eluting vertebral artery stents in the treatment of severe ostial vertebral rterystenosis

作　　者：晋永强 戴健 陈国栋 江学伟 刘超 汤璐璐 JIN Yongqiang;DAI Jian;CHEN Guodong;JIANG Xuewei;LIU Chao;TANG Lulu(Maanshan General Hospital of Ranger-Duree Healthcare,Maanshan,Anhui Province 243000,China)

机构地区：[1]德驭医疗马鞍山总医院,安徽马鞍山243000

出　　处：《介入放射学杂志》2024年第3期275-279,共5页Journal of Interventional Radiology

摘　　要：目的探讨雷帕霉素药物洗脱椎动脉支架治疗重度椎动脉起始部狭窄(OVAS)的临床效果及术后支架内再狭窄率。方法回顾性选取2020年11月至2022年5月于我院就诊行支架成形手术治疗的重度OVAS患者共96例,包括观察组(48例)和对照组(48例),观察组给予植入雷帕霉素洗脱椎动脉支架,对照组给予植入外周球囊扩张金属裸支架,观察对比围手术期基本情况、随访期间并发症发生情况和术后支架内再狭窄率。结果两组患者均成功植入支架,围手术期均未发生短暂性脑缺血发作(TIA)、支架脱落或断裂、椎动脉或支架相关脑卒中等并发症。两组患者手术植入的支架长度及支架管径均无明显差异(P>0.05),两组患者术前血管狭窄率及术后血管残余狭窄率差异均不显著(P>0.05),术后两组患者的残余狭窄率均小于20%。术后随访患者(12.33±5.82)个月,观察组和对照组患者椎动脉或支架相关的脑卒中发生率分别为0%和4.17%,无明显差异(P>0.05)。观察组47例和对照组45例患者头晕、眩晕等症状均较前改善,均未再发后循环TIA,均未发现支架相关血栓事件。观察组患者的支架植入术后再狭窄发生率(10.42%)明显低于对照组(29.17%,P<0.05)。结论雷帕霉素洗脱椎动脉支架能安全有效地治疗重度OVAS,且能减少术后支架内再狭窄率。Objective To investigate the clinical effect of rapamycin-eluting vertebral artery stent in the treatment of severe ostial vertebral artery stenosis(OVAS),and to analyze the incidence of postoperative instent restenosis(ISR).Methods A total of 96 patients with severe OVAS,who received stenting angioplasty at authors'hospital between November 2020 and May 2022,were retrospectively collected.The patients were divided into the observation group(n=48)and the control group(n=48).For the patients of the observation group implantation of rapamycin-eluting vertebral artery stent was carried out,while for the patients of the control group implantation of peripheral balloon dilatation bare metal stent(BMS)was performed.The perioperative basic data,the incidence of complications during follow-up period,and the postoperative incidence of ISR were compared between the two groups.Results Successful stent implantation was achieved in all patients of both groups.During perioperative period no complications such as transient ischemia attack(TIA),dropping-off or fracture of the stent,vertebral artery or stent-related stroke occurred.No statistically significant differences in the length and the diameter of the implanted stents,in the preoperative vertebral artery stenosis ratio,and in the postoperative residual stenosis ratio existed between the two groups(all P>0.05).In both groups,the postoperative residual stenosis ratio was<20%.The patients were followed up for a mean period of(12.33±5.82)months(range of 6-18 months),the incidence of postoperative vertebral artery or stent-related stroke in the observation group and the control group was 0%and 4.17%respectively,the difference between the two groups was not statistically significant(P>0.05).The improvement of clinical symptoms such as dizziness,vertigo,etc.was observed in 47 patients of the observation group and in 45 patients of the control group,and no recurrent posterior circulation TIA or stent-related thrombotic event occurred.The incidence of postoperative restenosis in

关 键 词：椎动脉狭窄 雷帕霉素 药物洗脱支架 支架内再狭窄 

分 类 号：R573.2[医药卫生—消化系统]