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使用Gateway-Wingspan系统进行颅内血管成形术治疗症状性动脉粥样硬化狭窄:27例中国患者的初步结果

Intracranial angioplasty with Gateway-Wingspan system for symptomatic atherosclerotic stenosis: preliminary results of 27 Chinese patients.

作者信息

Zhao Zhen-Wei, Deng Jian-Ping, He Shi-Ming, Qin Huai-Zhou, Gao Li, Gao Guo-Dong

机构信息

Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, China.

出版信息

Surg Neurol. 2009 Dec;72(6):607-11; discussion 611. doi: 10.1016/j.surneu.2009.06.017.

DOI:10.1016/j.surneu.2009.06.017
PMID:20082830
Abstract

BACKGROUND

We investigated the safety of treatment of symptomatic intracranial atherosclerotic stenoses with the Gateway-Wingspan system and its initial effect on prevention of ischemic events.

METHODS

Twenty-seven cases of symptomatic intracranial atherosclerotic stenoses were treated with angioplasty with a Wingspan stent. Location of stenoses, extent of stenoses before and after angioplasty, success rate of treatment, occurrence of procedural complications, and changes in recurrence of symptoms of ischemic events 30 days after treatment were recorded.

RESULTS

Twenty-nine angioplasties with the Wingspan system were successfully carried out in 29 stenoses in 27 patients. Of 29 stenoses, 17 were in the posterior circulation, and 12, in the anterior circulation. The degree of stenoses was reduced from baseline 71.8% (56%-87.8%) to 24.9% (0%-45%) after stenting. Complications were seen in four patients (14.8%), 3 of which were lesion-related infarction of a perforated artery, and 1 was a non-lesion-related infarction. Two complications led to transient neurologic dysfunction, one led to defect of the visual field, and one led to hemiplegia. The prevalence of morbidity and serious morbidity were 7.4% and 3.7%, respectively, and no death occurred. No new ischemic events happened during 30 days after stenting.

CONCLUSION

Angioplasty with the Wingspan system to treat symptomatic intracranial atherosclerotic stenoses appears to be safe. Its initial effect on prevention of ischemic events is acceptable.

摘要

背景

我们研究了使用Gateway-Wingspan系统治疗有症状的颅内动脉粥样硬化狭窄的安全性及其预防缺血性事件的初始效果。

方法

27例有症状的颅内动脉粥样硬化狭窄患者接受了Wingspan支架血管成形术治疗。记录狭窄部位、血管成形术前和术后的狭窄程度、治疗成功率、手术并发症的发生情况以及治疗后30天缺血性事件症状复发的变化。

结果

27例患者的29处狭窄成功进行了29次Wingspan系统血管成形术。29处狭窄中,17处位于后循环,12处位于前循环。支架置入后狭窄程度从基线的71.8%(56%-87.8%)降至24.9%(0%-45%)。4例患者(14.8%)出现并发症,其中3例为穿支动脉病变相关梗死,1例为非病变相关梗死。2例并发症导致短暂性神经功能障碍,1例导致视野缺损,1例导致偏瘫。发病率和严重发病率分别为7.4%和3.7%,无死亡发生。支架置入后30天内未发生新的缺血性事件。

结论

使用Wingspan系统进行血管成形术治疗有症状的颅内动脉粥样硬化狭窄似乎是安全的。其预防缺血性事件的初始效果是可以接受的。

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