Che Wuqiang, Xiong Hongliang, Jiang Xiongjing, Dong Hui, Zou Yubao, Yang Yuejin, Gao Runlin
Department of cardiology, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
Catheter Cardiovasc Interv. 2018 Feb 15;91(S1):623-631. doi: 10.1002/ccd.27492. Epub 2018 Jan 23.
To evaluate immediate and long-term clinical outcomes of stenting for middle aortic syndrome (MAS) caused by Takayasu arteritis (TA).
Studies of endovascular stenting for the treatment of MAS caused by TA are scare.
Data from 48 consecutive TA patients (mean 33.3 ± 12.6 years) with MAS treated by stenting in our institution between January 2010 and July 2016 were collected and retrospectively analyzed. Thirty-day and long-term follow-up clinical outcomes after aorta stenting were assessed.
Stenting was successful in all patients. The mean stenosis and peak systolic pressure gradient of aorta lesions were reduced from 81.3 ± 8.0% and 70.7 ± 18.4 mm Hg to 14.7 ± 8.3% and 14.0 ± 5.8 mm Hg immediately after the 54 stents were implanted. One patient developed retroperitoneal hemorrhage and one developed flow-limiting dissection that involved bilateral renal arteries perioperatively. Both patients recovered without sequela. Compared with baseline, the ankle brachial index (0.92 ± 0.19 vs. 0.75 ± 0.22), mean systolic blood pressure (149.5 ± 19.1 vs. 179.0 ± 28.4 mm Hg) and antihypertensive drugs (1.1 ± 0.7 vs. 3.1 ± 0.9) significantly improved after an average follow-up of 3.1 years (all P < .001). A total of 5 (10.9%) patients developed in-stent restenosis, which were resolved by reintervention (restenting in 3 patients and re-angioplasty alone in 2 patients). No major adverse events occurred during follow up.
Percutaneous aortic stenting is highly efficacious and safe in treating patients with MAS caused by TA with good immediate and long-term clinical outcomes.
评估经皮血管腔内支架置入术治疗大动脉炎（TA）所致主动脉中段综合征（MAS）的近期和长期临床疗效。
关于血管腔内支架置入术治疗TA所致MAS的研究较少。
收集2010年1月至2016年7月在我院接受支架置入术治疗的48例连续TA合并MAS患者（平均年龄33.3±12.6岁）的数据，并进行回顾性分析。评估主动脉支架置入术后30天及长期随访的临床疗效。
所有患者支架置入均成功。54枚支架置入后，主动脉病变的平均狭窄率和收缩期峰值压力阶差立即从81.3±8.0%和70.7±18.4 mmHg降至14.7±8.3%和14.0±5.8 mmHg。1例患者发生腹膜后出血，1例患者围手术期发生累及双侧肾动脉的限流性夹层。两名患者均康复且无后遗症。平均随访3.1年后，与基线相比，踝臂指数（0.92±0.19对0.75±0.22）、平均收缩压（149.5±19.1对179.0±28.4 mmHg）和抗高血压药物使用情况（1.1±0.7对3.1±0.9）均显著改善（均P<0.001）。共有5例（10.9%）患者发生支架内再狭窄，通过再次干预（3例再次置入支架，2例单纯再次血管成形术）得以解决。随访期间未发生重大不良事件。
经皮主动脉支架置入术治疗TA所致MAS疗效显著且安全，近期和长期临床疗效良好。
