WINGSPAN支架治疗重度症状性大脑中动脉粥样硬化狭窄的安全性和疗效

发布时间：2019-03-16 11:22

【摘要】：目的探究Wingspan支架治疗重度大脑中动脉粥样硬化性狭窄的安全性和长期疗效。方法从2012年9月至2014年10月从我院卒中数据库中连续登记纳入278例临床症状在90天以内,经脑血管造影证实大脑中动脉粥样硬化性狭窄超过70%的症状性卒中或短暂性脑缺血发作患者,行Wingspan支架置入术,并随访至2015年6月。终点事件为支架置入后30天内的卒中和死亡以及30天后术侧大脑中动脉供血区的缺血性卒中。结果278例患者中有277例(99.6%)成功置入了支架,平均狭窄率由术前的(82.5±7.9)%改善为术后的(9.0±3.2)%。在30天内共有12例(4.3%)患者发生终点事件,其中8例(2.9%)为出血性卒中,4例(1.4%)为缺血性卒中,围手术期死亡2例。在支架后随访的8~33个月期间共有19例患者发生终点事件,1年和2年终点事件率分别为5.8%(95%CI,5.0%-15.7%)和7.2%(95%CI,4.3%-10.1%)。结论Wingspan支架治疗重度症状性大脑中动脉粥样硬化性狭窄是安全有效的,支架后长期卒中复发率较低。
[Abstract]:Objective to evaluate the safety and long-term efficacy of Wingspan stent in the treatment of severe middle cerebral artery stenosis. Methods from September 2012 to October 2014, 278 patients with clinical symptoms were enrolled in our hospital apoplexy database from September 2012 to October 2014, and their clinical symptoms were within 90 days. Wingspan stenting was performed in patients with symptomatic stroke or transient ischemic attack with more than 70% middle cerebral atherosclerotic stenosis confirmed by cerebral angiography and followed up until June 2015. End-point events were stroke and death within 30 days after stent implantation and ischemic stroke in the blood supply region of the middle cerebral artery at the surgical side 30 days after stent implantation. Results of 278 patients, 277 patients (99.6%) successfully implanted stents. The average stenosis rate improved from (82.5 卤7.9)% before operation to (9.0 卤3.2)% after operation. Within 30 days, there were 12 patients (4.3%) with end-point events, 8 patients (2.9%) with hemorrhagic stroke, 4 patients (1.4%) with ischemic stroke, and 2 patients died during perioperative period. During the follow-up period of 8 to 33 months, 19 patients experienced end-point events. The 1-year and 2-year end-point events were 5.8% (95% CI, 5.0% + 15.7%) and 7.2% (95% CI), respectively, and the two-year follow-up rate was 5.8% (95% CI) and 7.2% (95% CI), respectively. (4.3% / 10.1%). Conclusion Wingspan stent is safe and effective in the treatment of severe symptomatic middle cerebral artery stenosis, and the recurrence rate of long-term stroke after stent is low.
【学位授予单位】：第三军医大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R743.3

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