Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, Nanjing, 210002, Jiangsu Province, China.
Cardiovasc Intervent Radiol. 2011 Feb;34(1):54-60. doi: 10.1007/s00270-010-9885-z. Epub 2010 May 11.
This study was designed to compare the clinical and angiographic outcomes of patients with symptomatic atherosclerotic middle cerebral artery stenosis treated with balloon-mounted stents (BMS) and self-expandable Wingspan system (SES). We reviewed the 69 consecutive stent placement procedures for symptomatic atherosclerotic stenosis (≥70) in M1 segment of middle cerebral artery in 67 patients in 3 years. According to the stent types, the patients were classed as BMS and SES groups. The demographic characteristics, conventional risk factors of ischemic stroke, degree of stenosis, periprocedural complications, stent types, and clinical and angiographic outcomes were analyzed. There were 39 patients in the BMS group and 28 patients in the SES group. The demographic characteristics, conventional risk factors, and periprocedural complications were similar but different in residual stenosis after stenting in both groups (5.9% ± 9.9% vs. 14.4% ± 14.6%; P = 0.01). For the overall cohort, the rate of stroke or death and restenosis was 10.9% (7/66) and 24.5% (14/57), respectively. The frequency of restenosis was higher in the SES group than in the BMS group (log-rank, P = 0.04; crude hazard ratio = 3.03; 95% confidence interval (CI), 1.01-9.15; P = 0.049; and adjusted hazard ratio = 3.61; 95% CI, 1.06-12.27; P = 0.04); however, there was no difference in clinical outcomes (log-rank, P = 0.51; crude hazard ratio = 1.66; 95% CI, 0.36-7.61; P = 0.51; and adjusted hazard ratio = 0.59; 95% CI, 0.04-7.89; P = 0.69). The corrected degree of restenosis was higher in the SES than the BMS group. The prevalence of restenosis was higher in the SES than the BMS group, but the perioperative complications and follow-up clinical outcomes had no significant difference.
本研究旨在比较症状性动脉粥样硬化性大脑中动脉狭窄患者接受球囊扩张支架（BMS）和自膨式 Wingspan 系统（SES）治疗的临床和血管造影结果。我们回顾了 3 年内 67 例患者的 69 例症状性动脉粥样硬化性狭窄（≥70）的支架置入术。根据支架类型，将患者分为 BMS 和 SES 组。分析了人口统计学特征、缺血性卒中的传统危险因素、狭窄程度、围手术期并发症、支架类型以及临床和血管造影结果。BMS 组 39 例，SES 组 28 例。两组患者的人口统计学特征、传统危险因素和围手术期并发症相似，但支架置入后残余狭窄程度不同（5.9%±9.9%比 14.4%±14.6%；P=0.01）。对于整个队列，卒中或死亡和再狭窄的发生率分别为 10.9%（7/66）和 24.5%（14/57）。SES 组的再狭窄率高于 BMS 组（log-rank，P=0.04；粗危险比=3.03；95%置信区间（CI），1.01-9.15；P=0.049；调整危险比=3.61；95%CI，1.06-12.27；P=0.04）；然而，临床结局无差异（log-rank，P=0.51；粗危险比=1.66；95%CI，0.36-7.61；P=0.51；调整危险比=0.59；95%CI，0.04-7.89；P=0.69）。SES 组的校正再狭窄程度高于 BMS 组。SES 组的再狭窄发生率高于 BMS 组，但 SES 组的围手术期并发症和随访临床结局无显著差异。
