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血管内支架置入术治疗颅内动脉狭窄的短期和长期疗效。

The short- and long-term efficacy of intravascular stenting in the treatment of intracranial artery stenosis.

作者信息

Jia Qiang, Yan Shixin

机构信息

Department of Neurosurgery, Tianjin Huanhu Hospital Tianjin, China.

Department of Radiology, Tianjin Huanhu Hospital Tianjin, China.

出版信息

Am J Transl Res. 2021 Jun 15;13(6):7115-7123. eCollection 2021.

Abstract

OBJECTIVE

To investigate the short- and long-term efficacy of intravascular stenting in the treatment of intracranial artery stenosis.

METHODS

This prospective study was conducted in 132 patients who underwent intravascular stenting for intracranial artery stenosis. In the perioperative period, complications were recorded. During a 2-year follow-up, postoperative stenosis rate, collateral circulation, changes in peak blood flow velocity, National Institute of Health stroke scale score, modified Rankin scale score, and restenosis were recorded. Factors influencing postoperative restenosis were analyzed using univariate analysis and multivariate logistic regression analysis.

RESULTS

In the perioperative period, 4 patients had complications, while 1 patient died. Compared with before operation, peak stenosis rate, blood flow velocity, National Institute of Health stroke scale score, and modified Rankin scale score at 1 year and 2 years after operation were significantly decreased, while the classification of collateral circulation was increased (all P<0.05). However, there were no statistical differences in the above indicators between 1-year and 2-year postoperative patients (all P>0.05). Two years after surgery, a total of 8 patients suffered from restenosis. There were statistical differences concerning age (≥70 years), the history of hypertension, diabetes, and coronary heart disease between the restenosis group and the non-restenosis group (all P<0.05). The results of multivariate analysis showed that the history of coronary heart disease and advanced age (≥70 years) were independent risk factors that affect the occurrence of postoperative restenosis.

CONCLUSION

The short- and long-term efficacy of intravascular stenting in the treatment of intracranial artery stenosis is significant. What's more, a history of coronary heart disease and advanced age (≥70 years) are independent risk factors contributing to postoperative restenosis.

摘要

目的

探讨血管内支架置入术治疗颅内动脉狭窄的短期和长期疗效。

方法

本前瞻性研究纳入了132例行颅内动脉狭窄血管内支架置入术的患者。记录围手术期并发症。在2年随访期间,记录术后狭窄率、侧支循环、峰值血流速度变化、美国国立卫生研究院卒中量表评分、改良Rankin量表评分及再狭窄情况。采用单因素分析和多因素logistic回归分析影响术后再狭窄的因素。

结果

围手术期,4例患者出现并发症,1例死亡。与术前相比,术后1年和2年的峰值狭窄率、血流速度、美国国立卫生研究院卒中量表评分及改良Rankin量表评分均显著降低,而侧支循环分级增加(均P<0.05)。然而,术后1年和2年患者上述指标比较差异无统计学意义(均P>0.05)。术后2年,共有8例患者发生再狭窄。再狭窄组与非再狭窄组在年龄(≥70岁)、高血压病史、糖尿病病史及冠心病病史方面差异有统计学意义(均P<0.05)。多因素分析结果显示,冠心病病史及高龄(≥70岁)是影响术后再狭窄发生的独立危险因素。

结论

血管内支架置入术治疗颅内动脉狭窄的短期和长期疗效显著。此外,冠心病病史及高龄(≥70岁)是导致术后再狭窄的独立危险因素。

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