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有症状的颅外和颅内动脉粥样硬化狭窄患者药物洗脱支架植入的长期疗效

Long-term outcomes of drug-eluting stent implantation in patients with symptomatic extra- and intracranial atherosclerotic stenoses.

作者信息

Kim Junhyung, Ban Seung Pil, Kim Young Deok, Kwon O-Ki

机构信息

Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Bundang, Korea.

出版信息

J Cerebrovasc Endovasc Neurosurg. 2020 Dec;22(4):216-224. doi: 10.7461/jcen.2020.E2020.09.001. Epub 2020 Oct 14.

Abstract

OBJECTIVE

Implantation of drug-eluting stents (DES) for extra- and intracranial atherosclerotic stenoses is an emerging topic. It has the potential benefit of preventing recurrent stroke with a reduced rate of in-stent restenosis (ISR).

METHODS

Patients who underwent extra- or intracranial stenting using DES in a single institution were retrospectively reviewed with long-term angiographic and clinical follow-up data.

RESULTS

Twenty-one patients, 9 (42.9%) with extracranial lesions and 12 (57.1%) with intracranial lesions, were included. The most common symptom was cerebral infarction (71.4%), followed by vertebrobasilar insufficiency (19.1%) and transient ischemic attack (9.5%). All patients achieved technical success, with the mean degree of stenosis of 85.9±6.3% before the procedure and 19.5±5.9% after the procedure. All patients showed clinical improvement and no symptomatic recurrence was reported during the mean clinical follow-up period of 45.5±8.9 months. The significant ISR was observed in one patient (4.8%) during the mean radiological follow-up period of 42.8±10.0 months.

CONCLUSIONS

Implantation of drug-eluting stents for symptomatic extra- and intracranial atherosclerotic stenoses is feasible and has the potential benefit of reducing the rate of ISR.

摘要

目的

药物洗脱支架(DES)植入治疗颅外和颅内动脉粥样硬化狭窄是一个新兴课题。它具有预防复发性卒中并降低支架内再狭窄(ISR)发生率的潜在益处。

方法

回顾性分析在单一机构接受DES颅外或颅内支架置入术患者的长期血管造影和临床随访数据。

结果

纳入21例患者,其中9例(42.9%)为颅外病变,12例(57.1%)为颅内病变。最常见症状为脑梗死(71.4%),其次为椎基底动脉供血不足(19.1%)和短暂性脑缺血发作(9.5%)。所有患者手术技术成功,术前平均狭窄程度为85.9±6.3%,术后为19.5±5.9%。所有患者临床症状均有改善,在平均45.5±8.9个月的临床随访期内未报告有症状复发。在平均42.8±10.0个月的影像学随访期内,1例患者(4.8%)出现显著的ISR。

结论

药物洗脱支架植入治疗有症状的颅外和颅内动脉粥样硬化狭窄是可行的,且具有降低ISR发生率的潜在益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2870/7820269/dbb0edf58848/jcen-2020-e2020-09-001f1.jpg

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