紫杉醇药物涂层球囊血管成形术治疗症状性椎动脉起始处狭窄疗效观察  

Clinical observation of paclitaxel drug-coated balloon angioplasty for symptomatic vertebral artery origin stenosis

作　　者：刘婧 马海玲[1] 徐坤[1] 何清 张岩[1] 刘建[1] LIU Jing;MA Hailing;XU Kun;HE Qing;ZHANG Yan;LIU Jian(The First People’s Hospital of Xuzhou,Xuzhou 221000,China)

机构地区：[1]徐州市第一人民医院,江苏徐州221000

出　　处：《中国实用神经疾病杂志》2024年第8期941-945,共5页Chinese Journal of Practical Nervous Diseases

基　　金：徐州市卫生健康委科技项目(编号:XWKYHT20220084);江苏省卫生应急研究所课题(编号:JSWSYJ-20220303)。

摘　　要：目的观察紫杉醇药物涂层球囊(P-DCB)成形术治疗症状性椎动脉起始处狭窄(VAOS)的临床疗效及安全性。方法回顾性分析2020-01—2021-12徐州市第一人民医院采用P-DCB治疗的51例症状性VAOS患者的临床资料。评估术前及术后即刻的狭窄程度,记录围手术期并发症,采用NIHSS评分、mRS评分评价神经功能和日常生活能力,随访时行CTA检查以明确再狭窄情况。结果最终纳入完成P-DCB治疗患者51例,年龄(67.7±9.2)岁。术后即刻狭窄率(34.0±6.7)%,明显低于术前的(87.8±8.7)%,差异有统计学意义(P<0.05)。术中发生椎动脉夹层1例,未特殊处理;围手术期未发生30 d内死亡、颅内出血、TIA和与椎动脉狭窄相关的卒中。患者术后随访时NIHSS评分、mRS评分较术前明显降低,差异均有统计学意义(P<0.05)。随访6~12个月,所有患者均接受CTA检查,椎动脉起始处狭窄率为(42.3±9.3)%,与术后即刻狭窄率相比,差异有统计学意义(P<0.05);共11例发生无症状性再狭窄,再狭窄发生率为21.6%。结论P-DCB成形术治疗症状性VAOS可有效缓解患者症状,改善椎基底动脉血流,手术并发症发生率低。Objective To observe the clinical efficacy and safety of paclitaxel drug-coated balloon(P-DCB)plasty for symptomatic vertebral artery origin stenosis(VAOS).Methods The clinical data of 51 patients with symptomatic VAOS treated by P-DCB in the First People’s Hospital of Xuzhou from January 2020 to December 2021 were retrospectively analyzed.The degree of stenosis was assessed preoperatively and in the immediate postoperative period,perioperative complications were recorded,neurological function and daily living ability were evaluated using the NIHSS score and the mRS score,and CTA was performed at the time of follow-up to clarify restenosis.Results A total of 51 patients,aged(67.7±9.2)years,who had completed P-DCB treatment were included.The stenosis rate in the immediate postoperative period was(34.0±6.7)%,which was significantly lower than(87.8±8.7)%in the preoperative period,and the difference was statistically significant(P<0.05).One case of vertebral artery entrapment occurred intraoperatively,which was not specifically treated;no death,intracranial hemorrhage,TIA,or stroke related to vertebral artery stenosis occurred in the perioperative period within 30 days.Patients’NIHSS scores and mRS scores were significantly lower postoperative follow-up compared with those preoperative,and the differences were statistically significant(P<0.05).At 6 to 12 months of follow-up,all patients underwent CTA,and the stenosis rate at the beginning of the vertebral artery was(42.3±9.3)%,compared with the stenosis rate in the immediate postoperative period,the difference was statistically significant(P<0.05).A total of 11 cases experienced asymptomatic restenosis,and the incidence of restenosis was 21.6%.Conclusion P-DCB plasty for symptomatic VAOS can effectively relieve patients’symptoms,improve vertebrobasilar artery blood flow,and has low surgical complications.

关 键 词：椎动脉起始处狭窄 紫杉醇 药物涂层球囊成形术 再狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]