Department of Neurology and Interventional Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
J Neurointerv Surg. 2020 Mar;12(3):274-278. doi: 10.1136/neurintsurg-2019-015035. Epub 2019 Jul 8.
To evaluate the clinical outcomes of early stenting (≤14 days) or late stenting (>14 days) in patients who underwent intracranial stent placement.
Patients with ischemic stroke caused by 70-99% intracranial atherosclerotic stenosis combined with poor collaterals were enrolled. The early stenting group, who underwent stenting within 14 days of last ischemic symptoms, were compared with the late stenting group who underwent stenting >14 days from last ischemic symptom. The patients were treated either with a balloon-mounted stent or a self-expanding stent as determined by the operators following a guideline. The baseline characteristics and clinical outcomes were evaluated and compared.
One hundred and fifteen stroke patients were recruited into the study. Four patients (4/41) in the early stenting group and two patients (2/74) in the late stenting group were diagnosed with a cerebral vascular event associated with stenting within 3 days (p=0.184). In the long-term follow-up, eight patients in the early stenting group had restenosis ≥50%, which was higher than patients in the late stenting group (8/41 vs 4/74, p=0.018). The total rates of any ischemic stroke, transient ischemic attack, hemorrhagic stroke, and death in the early stenting group were higher than in the late stenting group (9/41 vs 6/74, p=0.035). The recurrence rate of ischemic stroke in the early stenting group was higher than in the late stenting group (5/41 vs 2/74, p=0.041).
Stent placement in the setting of ischemic stroke caused by intracranial artery stenosis within 14 days may confer a higher risk of long-time cerebral vascular events and lead to a higher risk of restenosis.
NCT01968122.
评估颅内支架置入术后早期（≤14 天）或晚期（＞14 天）支架置入的临床结局。
纳入因 70-99%颅内动脉粥样硬化性狭窄合并较差侧支循环而导致缺血性脑卒中的患者。早期支架置入组在最后一次缺血症状后 14 天内行支架置入，与晚期支架置入组（末次缺血症状后＞14 天行支架置入）进行比较。根据操作者遵循指南的决定，使用球囊扩张支架或自膨式支架进行治疗。评估和比较患者的基线特征和临床结局。
本研究共纳入 115 例脑卒中患者。早期支架置入组 4 例（4/41）和晚期支架置入组 2 例（2/74）在 3 天内诊断出与支架相关的脑血管事件（p=0.184）。在长期随访中，早期支架置入组有 8 例出现≥50%的再狭窄，高于晚期支架置入组（8/41 例比 4/74 例，p=0.018）。早期支架置入组总的任何缺血性卒、短暂性脑缺血发作、出血性卒中和死亡发生率高于晚期支架置入组（9/41 例比 6/74 例，p=0.035）。早期支架置入组缺血性卒中复发率高于晚期支架置入组（5/41 例比 2/74 例，p=0.041）。
在颅内动脉狭窄引起的缺血性脑卒中患者中，14 天内支架置入可能会增加长期脑血管事件的风险，并导致更高的再狭窄风险。
NCT01968122。
