不同类型颈动脉支架对治疗结果的影响：来自欧洲颈动脉支架置入登记研究的结果

Impact on outcome of different types of carotid stent: results from the European Registry of Carotid Artery Stenting.

作者信息

Stabile Eugenio, Giugliano Giuseppe, Cremonesi Alberto, Bosiers Marc, Reimers Bernhard, Setacci Carlo, Cao Piergiorgio, Schmidt Andrej, Sievert Horst, Peeters Patrick, Nikas Dimitrios, Sannino Anna, de Donato Gianmarco, Parlani Giambattista, Castriota Fausto, Hornung Marius, Rubino Paolo, Esposito Giovanni, Tesorio Tullio

机构信息

Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

出版信息

EuroIntervention. 2016 Jun 12;12(2):e265-70. doi: 10.4244/EIJV12I2A41.

DOI:10.4244/EIJV12I2A41

PMID:27290686

Abstract

AIMS

Conflicting data exist on the impact on outcome of the use of different stent types during carotid artery stenting (CAS). The aim of this study was to evaluate clinical outcomes according to different carotid stent design among the population of the European Registry of Carotid Artery Stenting (ERCAS).

METHODS AND RESULTS

The present study was conducted in 1,604 patients who underwent neuroprotected CAS in ERCAS. All types of commercially available carotid stent were used. Open-cell design stents were classified according to free cell area into <7.5 mm2 or >7.5 mm2. A total of 713 closed-cell, 456 hybrid-cell, 238 <7.5 mm2 open-cell, and 197 >7.5 mm2 open-cell stents were implanted. Overall, the 30-day stroke and death rate was 1.37%. At 30 days, 19 strokes occurred (1.18%): eight in the group of patients treated with a closed-cell (1.12%), two in those with a hybrid-cell (0.44%), three in those with a <7.5 mm2 open-cell (1.26%), and six in those treated with a >7.5 mm2 open-cell stent (3.05%) (p=0.045).

CONCLUSIONS

Data of the present study suggest that, in the setting of neuroprotected CAS performed in high-volume centres by properly trained operators, the use of an open-cell design stent with a free cell area >7.5 mm2 may be associated with an increased 30-day stroke risk.

摘要

目的

关于颈动脉支架置入术（CAS）中使用不同类型支架对预后的影响，存在相互矛盾的数据。本研究的目的是在欧洲颈动脉支架置入术注册研究（ERCAS）人群中，根据不同的颈动脉支架设计评估临床预后。

方法与结果

本研究纳入了1604例在ERCAS中接受神经保护下CAS的患者。使用了所有类型的市售颈动脉支架。开放式设计支架根据自由细胞面积分为<7.5 mm²或>7.5 mm²。共植入了713个封闭式、456个混合式、238个<7.5 mm²开放式和197个>7.5 mm²开放式支架。总体而言，30天的卒中及死亡率为1.37%。在30天时，发生了19例卒中（1.18%）：封闭式支架治疗组中有8例（1.12%），混合式支架治疗组中有2例（0.44%），<7.5 mm²开放式支架治疗组中有3例（1.26%），>7.5 mm²开放式支架治疗组中有6例（3.05%）（p=0.045）。