新疆地区缺血性脑卒中患者颅外段脑血管支架治疗长期随访分析
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(新疆医科大学第一附属医院神经内科,新疆维吾尔自治区乌鲁木齐市 830054)

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阿力木·吾甫尔, 硕士,主治医师, 研究方向为脑血管病, E-mail为alim013@163.com。

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Long follow-up analysis of stenting in the patients with extracranial cerebral artery stenosis in Xinjiang
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Department of Neurology,the First Affiliated Hospital,Xinjiang Medical University,Urumqi,Xinjiang 830054, China)

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    摘要:

    目的 评价新疆地区颅外段脑动脉狭窄患者颈动脉血管支架置入术(CAS)和椎动脉起始端支架置入术(VAOS)治疗的安全性和有效性。 方法 颅外段颈动脉狭窄或椎动脉起始部狭窄患者323例,回顾性分析其CAS和VAOS术前和术后随访记录,分析支架置入成功率、围术期并发症,及随访期间支架置入后再狭窄率和临床终点事件的发生率。 结果 CAS和VAOS组手术成功率为100%,围手术期并发症发生率分别为14.4%和1.2%,随访期间临床终点事件的发生率分别为15.1%和12.8%,再狭窄的发生率为8.8%和13.4%,Cox回归分析发现在CAS组中,男性和多支血管病变为发生再狭窄的危险因素( HR=19.249,P=0.02;HR=0.069,P=0.034);VAOS组中,对侧椎动脉狭窄为发生再狭窄的危险因素(HR=0.075,P=0.001)。 结论 CAS和VAOS治疗颅外段动脉狭窄相对安全,但应重视术中及术后并发症的预防及处理。

    Abstract:

    Aim To assess the safety and effect of stent implantation in patients with extracranial cerebral artery stenosis in Xinjiang. Methods From 2009 to 2015, in our hospital, three hundred and twenty-three patients with symptomatic extracranial cerebral artery stenosis underwent carotid artery stenting(CAS)or vertebral artery ostium stenting (VAOS) operation. Their success rate of stent implantation,incidence of perioperative complications,and restenosis during follow-up period, modified Rankin scale(mRS)scores and events at clinical end point were compared and analyzed.Results The success rate of stent implantation in CAS and VAOS was 100%respectively,the incidence of peroperative complications was 14.4% and 1.2% respectively,the incidence of events at clinical end point was 15.1% and 12.8%. The incidence of restenosis was 8.8% and 13.4% respectively. Cox multivariate regression analysis revealed that male and multiple artery stenosis were the independent risk factors in CAS group( HR=19.249, P=0.02;HR=0.069, P=0.034), and contralateral vertebral artery stenosis was the independent risk factors in VAOS group( HR=0.075, P=0.001). Conclusion CAS and VAOS are safe and effective methods to treat extracranial cerebral artery stenosis, however, we should pay attention to the prevention and treatment of its complications.

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阿力木·吾甫尔,哈力旦·加马力丁,夏提古力·亚力坤,马建华,张小宁.新疆地区缺血性脑卒中患者颅外段脑血管支架治疗长期随访分析[J].中国动脉硬化杂志,2017,25(3):284~287.

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  • 收稿日期:2016-08-19
  • 最后修改日期:2016-12-28
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  • 在线发布日期: 2017-03-28