症状性颅内动脉狭窄颅内支架置入术后亚急性血栓形成的危险因素
Risk Factors of Subacute Thrombosis After Intracranial Stenting for Symptomatic Intracranial Arterial Stenosis.
作者信息
Sun Xuan, Tong Xu, Lo Wai Ting, Mo Dapeng, Gao Feng, Ma Ning, Wang Bo, Miao Zhongrong
机构信息
From the Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University, China (X.S., D.M., F.G., N.M., B.W., Z.M.); Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China (X.S., D.M., F.G., N.M., B.W., Z.M.); China National Clinical Research Center for Neurological Diseases Center of Stroke, Beijing (X.S., D.M., F.G., N.M., B.W., Z.M.); Beijing Institute for Brain Disorders, China (X.S., D.M., F.G., N.M., B.W., Z.M.); Department of Neurology, Tangshan Gongren Hospital, Hebei Medical University, China (X.T.); and Department of Medicine, Queen Elizabeth Hospital, Hong Kong, China (W.T.L.).
出版信息
Stroke. 2017 Mar;48(3):784-786. doi: 10.1161/STROKEAHA.116.015538. Epub 2017 Jan 27.
BACKGROUND AND PURPOSE
We aimed to explore the risk factors of subacute thrombosis (SAT) after intracranial stenting for patients with symptomatic intracranial arterial stenosis.
METHODS
From January to December 2013, all symptomatic intracranial arterial stenosis patients who underwent intracranial stenting in Beijing Tiantan Hospital were prospectively registered into this study. Baseline clinical features and operative data were compared in patients who developed SAT with those who did not. Binary logistic regression model was used to determine the risk factors associated with SAT.
RESULTS
Of the 221 patients enrolled, 9 (4.1%) cases had SAT 2 to 8 days after stenting. Binary logistic analysis showed that SAT was related with tandem stenting (odds ratio [OR], 11.278; 95% confidence interval [CI], 2.422-52.519) and antiplatelet resistance (aspirin resistance: OR, 6.267; 95% CI, 1.574-24.952; clopidogrel resistance: OR, 15.526; 95% CI, 3.105-77.626; aspirin and clopidogrel resistance: OR, 12.246; 95% CI, 2.932-51.147; and aspirin or clopidogrel resistance: OR, 11.340; 95% CI, 2.282-56.344).
CONCLUSIONS
Tandem stenting and antiplatelet resistance might contribute to the development of SAT after intracranial stenting in patients with symptomatic intracranial arterial stenosis.
背景与目的
我们旨在探讨症状性颅内动脉狭窄患者颅内支架置入术后亚急性血栓形成（SAT）的危险因素。
方法
2013年1月至12月，在北京天坛医院接受颅内支架置入术的所有症状性颅内动脉狭窄患者均被前瞻性纳入本研究。对发生SAT的患者与未发生SAT的患者的基线临床特征和手术数据进行比较。采用二元逻辑回归模型确定与SAT相关的危险因素。
结果
在纳入的221例患者中，9例（4.1%）在支架置入术后2至8天发生SAT。二元逻辑分析显示，SAT与串联支架置入（比值比[OR]，11.278；95%置信区间[CI]，2.422 - 52.519）和抗血小板抵抗（阿司匹林抵抗：OR，6.267；95% CI，1.574 - 24.952；氯吡格雷抵抗：OR，15.526；95% CI，3.105 - 77.626；阿司匹林和氯吡格雷抵抗：OR，12.246；95% CI，2.932 - 51.147；以及阿司匹林或氯吡格雷抵抗：OR，11.340；95% CI，2.282 - 56.344）有关。
结论
串联支架置入和抗血小板抵抗可能促使症状性颅内动脉狭窄患者颅内支架置入术后发生SAT。
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