支架与药物治疗症状性颅内动脉狭窄远期疗效对比

发布时间：2018-01-15 05:05

  本文关键词：支架与药物治疗症状性颅内动脉狭窄远期疗效对比　出处：《介入放射学杂志》2016年02期 　论文类型：期刊论文

  更多相关文章： 症状性颅内动脉狭窄 Wingspan支架 Solitaire支架 药物

【摘要】：目的对比分析支架植入与药物治疗症状性中重度颅内动脉狭窄的远期随访疗效。方法采用回顾性研究、Kaplan-Meier法生存分析、Cox回归模型等统计方法,对199例症状性中重度颅内动脉狭窄患者经支架植入与单纯药物治疗的临床资料进行对比分析,比较两种治疗方式的安全有效性及近、远期获益差异。结果 Apollo、Wingspan、Solitaire支架植入成功率分别为100%、97.4%、98.5%,即刻残余狭窄分别由术前(70.20±12.02)%、(78.61±12.15)%、(78.44±11.82)%下降至术后(18.00±6.33)%、(23.65±10.71)%、(17.21±8.02)%。支架植入组9例(8.5%)发生围手术期并发症,其中术中栓子脱落、穿支闭塞4例,急性血栓形成1例,血管迷走神经反射2例,再灌注脑出血1例,术后第5天动脉-动脉栓塞事件1例。支架植入组与药物治疗组患者间主要终点事件发生率和累积发生率差异均无统计学意义(P=0.824,P=0.867)。结论 Solitaire支架和Wingspan支架植入治疗症状性颅内动脉狭窄均具有良好的安全有效性,远期获益与药物治疗相比无显著差异。
[Abstract]:Objective to compare the long-term follow-up results of stenting and drug therapy for symptomatic moderate and severe intracranial artery stenosis. Methods Kaplan-Meier survival analysis was performed retrospectively. The clinical data of 199 patients with symptomatic moderate and severe intracranial artery stenosis treated by stenting and drug therapy were analyzed by Cox regression model. Results the success rate of Apollo Wingspande Solitaire stent implantation was 100% respectively. 97.4% of the patients had immediate residual stenosis from 70.20 卤12.02% to 78.61 卤12.15%. 78.44 卤11.82% decreased to 18.00 卤6.33% and 23.65 卤10.71%. The perioperative complications occurred in the stent implantation group (9 cases, 8.5%), in which the embolus fell off, perforating branch was occluded in 4 cases, and acute thrombosis occurred in 1 case. Two cases were vasovagal reflex and one case was cerebral hemorrhage after reperfusion. There was no significant difference in the incidence and cumulative incidence of major end point events between the stenting group and the drug treatment group on the 5th day after operation (P < 0. 824). Conclusion both Solitaire stents and Wingspan stents are safe and effective in the treatment of symptomatic intracranial artery stenosis. There was no significant difference in long-term benefits compared with drug therapy.
【作者单位】： 广州中医药大学;山东省临沂市中医医院;广东省中医院脑病中心;
【分类号】：R743.3
【正文快照】： 颅内动脉粥样硬化性狭窄(ICAS)是缺血性卒中发病与复发的重要原因,其狭窄程度每提高10%,发生缺血性脑血管病的危险就增加26%[1]。ICAS患者各种原因所致年度卒中风险为3.6%~13%[2-3],症状性ICAS患者卒中发病率及复发率更高[4-5]。因此,积极有效干预ICAS对降低卒中发病率、复发，

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