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血管成形术和支架置入术治疗颅内椎基底动脉严重症状性动脉粥样硬化狭窄

Angioplasty and stenting for severe symptomatic atherosclerotic stenosis of intracranial vertebrobasilar artery.

作者信息

Zhou Yu, Wang Li, Zhang Jian-Rong, Zhou Kai, Shuai Jie, Gong Zi-Li, Liu Yong, Wei Fei, Han Yu-Fu, Shen Lin, Yang Qing-Wu

机构信息

Department of Neurology, Xinqiao Hospital & the Second Affiliated Hospital, the Army (Third Military) Medical University, Chongqing, China.

Department of Neurology, Xinqiao Hospital & the Second Affiliated Hospital, the Army (Third Military) Medical University, Chongqing, China.

出版信息

J Clin Neurosci. 2019 May;63:17-21. doi: 10.1016/j.jocn.2019.02.017. Epub 2019 Mar 6.

Abstract

This retrospective study is to investigate the safety and efficacy of the stent implanting for treating severe symptomatic atherosclerotic stenosis of the intracranial vertebrobasilar artery (ICVBA). 213 patients who had undergone intervention for severe symptomatic ICVBA stenosis between September 2012 to May 2018 were enrolled into this study. Among the 213 enrolled patients, 210 patients (98.6%) obtained successfully revascularization and 206 patients (96.7%) had good revascularization after stenting. The extent of stenosis before and after intervention was 86.3 ± 6.8% and 9.1 ± 3.7%, respectively. Within 90 days after stenting, 10 patients (4.7%) experienced primary endpoint events, including 4 cases (4.2%) in the intracranial vertebral artery (V4) group and 6 (5.1%) in basilar artery (BA) group. Among them, 2 (2.1%) and 3 cases (2.5%) of ischemic stroke in V4 and BA group, respectively; and 2 (2.1%) and 2 (1.7%) cases of TIA in V4 and BA group, respectively. One (0.8%) case in the BA group dead because of the acute stent occlusion resulted in the top of the basilar syndrome. Six patients (2.8%) experienced adverse events, including 2 (2.1%) and 4 (3.4%) cases of groin hematoma in the V4 and BA group, respectively. No cases of hemorrhagic stroke, stent dislocation and vessel dissection in both groups. Our study showed that a low complication rate and a high and good revascularization rate would be achieved by the treatment of severe symptomatic atherosclerotic stenosis of the ICVBA using the stents.

摘要

本回顾性研究旨在探讨支架植入术治疗颅内椎基底动脉(ICVBA)严重症状性动脉粥样硬化狭窄的安全性和有效性。纳入2012年9月至2018年5月期间因严重症状性ICVBA狭窄接受干预的213例患者。在这213例纳入患者中,210例(98.6%)成功实现血运重建,206例(96.7%)支架置入术后血运重建良好。干预前后狭窄程度分别为86.3±6.8%和9.1±3.7%。支架置入后90天内,10例(4.7%)发生主要终点事件,其中颅内椎动脉(V4)组4例(4.2%),基底动脉(BA)组6例(5.1%)。其中,V4组和BA组分别有2例(2.1%)和3例(2.5%)发生缺血性卒中;V4组和BA组分别有2例(2.1%)和2例(1.7%)发生短暂性脑缺血发作(TIA)。BA组1例(0.8%)因急性支架闭塞导致基底动脉尖综合征死亡。6例(2.8%)发生不良事件,其中V4组和BA组分别有2例(2.1%)和4例(3.4%)发生腹股沟血肿。两组均未发生出血性卒中、支架移位和血管夹层。我们的研究表明,使用支架治疗ICVBA严重症状性动脉粥样硬化狭窄可实现低并发症率和高且良好的血运重建率。

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