Wang Jun, Zhong Changyang, Zhang Yan, Wei Yingnan, Liu Huili, Wu Chunli, Yan Yongxing
Department of Neurology, Hangzhou Clinical College of Medical University of Anhui; Hangzhou Third Hospital, Hangzhou, P.R. China.
Interv Neuroradiol. 2018 Feb;24(1):43-50. doi: 10.1177/1591019917736032. Epub 2017 Oct 23.
Objective Endovascular stent-assistant angioplasty (ESAA) is a valid treatment for symptomatic vertebrobasilar artery stenosis (SVAS), but the long-term effect and the improvement of condition compared with medication treatment are unknown. This study investigated the long-term efficacy of ESAA in patients with moderate and severe SVAS, and compared the efficacy with medication treatment. Materials and methods We conducted a retrospective analysis of clinical data of 43 patients with moderate and severe SVAS hospitalized in our department. According to different treatment methods they were divided into 29 cases in an ESAA group and 14 cases in a medication treatment group. During the follow-up period, the degree of vascular stenosis, vascular blood flow velocity, restenosis rate, recovery of neurological function and the incidence of cerebral ischemic events in the two groups were analyzed. Results The average clinical follow-up period was 89.4 ± 10.2 months. Before treatment, the stenosis rate and average blood flow velocity of the two groups were not statistically significant ( p > 0.05). During the follow-up period, both were significantly lower than the medication treatment group ( p < 0.01). In the ESAA group, three cases of stent stenosis, and three cases in the medication treatment group were completely occluded. The total ischemic events in ESAA group were three cases, compared with nine cases in the medication treatment group; the difference was statistically significant ( p < 0.05). Conclusion ESAA has a long-term effect in the treatment of symptomatic moderate and severe vertebrobasilar artery stenosis. It is superior to medication therapy in preventing posterior circulation ischemia (PCI), but a larger sample size is still needed to confirm the study.
目的 血管内支架辅助血管成形术（ESAA）是症状性椎基底动脉狭窄（SVAS）的一种有效治疗方法，但与药物治疗相比，其长期疗效及病情改善情况尚不清楚。本研究探讨了ESAA治疗中重度SVAS患者的长期疗效，并与药物治疗的疗效进行比较。 材料与方法 对我科收治的43例中重度SVAS患者的临床资料进行回顾性分析。根据不同治疗方法将其分为ESAA组29例和药物治疗组14例。随访期间，分析两组血管狭窄程度、血管血流速度、再狭窄率、神经功能恢复情况及脑缺血事件发生率。 结果 平均临床随访时间为89.4±10.2个月。治疗前，两组狭窄率和平均血流速度差异无统计学意义（p＞0.05）。随访期间，两者均显著低于药物治疗组（p＜0.01）。ESAA组有3例支架狭窄，药物治疗组有3例完全闭塞。ESAA组总缺血事件为3例，药物治疗组为9例；差异有统计学意义（p＜0.05）。 结论 ESAA治疗症状性中重度椎基底动脉狭窄有长期疗效。在预防后循环缺血（PCI）方面优于药物治疗，但仍需更大样本量来证实本研究。
