Enterprise支架置入术治疗有症状大脑中动脉粥样硬化狭窄的有效性和安全性  

Efficacy and safety of Enterprise stenting in the treatment of symptomatic middle cerebral artery atherosclerotic stenosis

作　　者：张贺 马莉[1] 端光鑫 张曦 张挺正 罗云[1] 徐运[1] 李敬伟[1] Zhang He;Ma Li;Duan Guangxin;Zhang Xi;Zhang Tingzheng;Luo Yun;Xu Yun;Li Jingwei(Department of Neurology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院神经内科,南京210008

出　　处：《国际脑血管病杂志》2024年第7期481-486,共6页International Journal of Cerebrovascular Diseases

基　　金：国家自然科学基金青年科学基金(82101396)。

摘　　要：目的探讨Enterprise支架置入术治疗有症状大脑中动脉粥样硬化狭窄的有效性和安全性。方法回顾性纳入2020年1月至2022年12月期间在南京大学医学院附属鼓楼医院神经内科接受Enterprise支架置入术的有症状大脑中动脉粥样硬化狭窄患者。评估残余狭窄程度、围操作期并发症、随访期间支架内再狭窄和卒中复发。结果共纳入75例患者,男性55例(73.3%),年龄(58±9.7)岁。术前最后一次发作症状为卒中65例(86.7%),短暂性脑缺血发作10例(13.3%)。大脑中动脉M1段狭窄67例(89.3%),M2段狭窄8例(10.7%),狭窄程度为88.4%±8.90%。最后一次发作至支架置入的中位时间为18 d(四分位数间距:13~24 d)。手术成功率100%,残余狭窄程度为17.3%±6.1%。4例(5.3%)患者发生围操作期并发症,包括3例缺血性卒中和1例有症状颅内出血。61例(81.3%)患者完成3~12个月的随访,其中7例(11.5%)发生支架内再狭窄,2例(3.3%)复发缺血性卒中。结论Enterprise支架置入术治疗有症状大脑中动脉粥样硬化狭窄可能是安全和有效的。ObjectiveTo investigate the efficacy and safety of Enterprise stenting in the treatment of symptomatic middle cerebral artery atherosclerotic stenosis.MethodsPatients with symptomatic middle cerebral artery atherosclerotic stenosis underwent Enterprise stenting in the Department of Neurology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School from January 2020 to December 2022 were retrospectively included.The degree of residual stenosis,periprocedural complications,in-stent restenosis and stroke recurrence during follow-up were evaluated.ResultsA total of 75 patients were enrolled,including 55 males(73.3%),aged 58±9.7 years.The last preprocedural symptom was stroke in 65 cases(86.7%)and transient ischemic attack in 10 cases(13.3%).Sixty-seven patients(89.3%)had the M1 segment stenosis of the middle cerebral artery,and 8(10.7%)had the M2 segment stenosis.The degree of stenosis was 88.4%±8.90%.The median time from the last onset to stenting was 18 days(interquartile range,13-24 days).The procedural success rate was 100%,and the residual stenosis degree was 17.3%±6.1%.Four patients(5.3%)experienced periprocedural complications,including three ischemic strokes and one symptomatic intracranial hemorrhage.Sixty-one patients(81.3%)completed 3-to 12-month follow-up,of which 7 patients(11.5%)had in-stent restenosis and 2(3.3%)had recurrent ischemic stroke.ConclusionEnterprise stenting may be safe and effective in the treatment of symptomatic middle cerebral artery stenosis.

关 键 词：颅内动脉硬化 大脑中动脉 缺血性卒中 脑缺血发作 短暂性 血管内手术 支架 治疗结果 复发 

分 类 号：R651.12[医药卫生—外科学]