DU Bin, Dong Ke-hui, Xu Xiao-tong, Ma Ning, Jin Min, Jiang Wei-jian
Department of Emergency Interventional Radiology, Beijing Tiantan Hospital, Capital University of Medical Sciences, Beijing 100050, China.
Zhonghua Nei Ke Za Zhi. 2007 Mar;46(3):204-7.
To evaluate the safety, feasibility and long-term results of stent-assisted angioplasty in atherosclerotic ostial stenosis of vertebral artery (VA).
Forty one patients (48 lesions) with symptomatic cerebral ischemic events or stroke attributed to VA atherosclerotic ostial stenosis > or = 50% (NASCET method) found in digital subtraction angiography (DSA) were approached for consent to participate in the study. During the procedure, three cases used protection devices and three used drug-eluting stents.
Thirty seven of the patients were male and 4 female. Mean age was 63.4 years (range 36 - 80). Technical success was achieved in 97.9 % of the lesions. One suffered from a stroke that occurred within 30-days postprocedural. 37 patients were followed up for 22.4 months. The clinical follow-up outcomes showed that there were no lesion-related strokes and deaths, three appeared to have return of neurological symptoms (TIA). Among the 21 patients (26 lesions) who had angiography follow-up, re-stenosis (> or = 50%) was revealed in 9 patients (9 lesions) (34.6%). However, seven of these 9 patients remained asymptomatic.
Stent-assisted angioplasty for atherosclerotic ostial stenosis of VA is safe and feasible. It can prevent the lesion-related stroke, death and TIA recurrence. However, further studies are needed to clarify how to reduce the relatively high re-stenosis rate.
评估支架辅助血管成形术治疗椎动脉（VA）粥样硬化性开口狭窄的安全性、可行性及长期疗效。
41例（48处病变）因数字减影血管造影（DSA）发现VA粥样硬化性开口狭窄≥50%（采用北美症状性颈动脉内膜切除术协作研究组（NASCET）方法）导致有症状性脑缺血事件或中风的患者被邀请参加本研究并获同意。在手术过程中，3例使用了保护装置，3例使用了药物洗脱支架。
患者中男性37例，女性4例。平均年龄63.4岁（范围36 - 80岁）。97.9%的病变手术成功。1例在术后30天内发生中风。37例患者接受了22.4个月的随访。临床随访结果显示，无病变相关的中风和死亡，3例出现神经症状复发（短暂性脑缺血发作（TIA））。在21例（26处病变）接受血管造影随访的患者中，9例（9处病变）（34.6%）出现再狭窄（≥50%）。然而，这9例患者中有7例仍无症状。
支架辅助血管成形术治疗VA粥样硬化性开口狭窄是安全可行的。它可以预防病变相关的中风、死亡及TIA复发。然而，需要进一步研究以阐明如何降低相对较高的再狭窄率。
