中国脑血管病杂志2012，Vol.9Issue(11)：577-580,4.DOI:10.3969/j.issn.1672-5921.2012.11.005
超声评估椎动脉起始段支架置入后残余狭窄及支架位置对其的影响
Ultrasound evaluation of residual stenosis after vertebral artery origin stenting and influence of the site of stent
摘要
Abstract
Objective To evaluate the correlations of the site,type and length of stent and the incidence of residual stenosis of vertebral artery origin stenting ( VAOS) with color Doppler flow imaging (CDFI). Methods A total of 177 patients (192 stents) with atherosclerotic stenosis at the vertebral artery origin treated with stenting from January 2009 to September 2011 were enrolled prospectively. They were grouped according to the lengths (L) ,sites (SS) and stent types. The changes of the diameter at the vertebral artery origin, peak systolic velocity ( PSV ) and end diastolic velocity ( EDV) before procedure and 1 week after procedure were compared using CDFI. The incidence of residual stenosis after procedure was evaluated. The incidence of residual stenosis was analyzed in different groups. The digital subtraction angiography ( DSA) images immediately after procedures and the results of CDFI re-examination within 1 week were evaluated. The in-stent residual stenosis ≥ 20% was defined as residual stenosis. Results ①According to the results of DSA,84 LI (15mm) stents,51 L2 ( > 15 mm) stents, and 57 L3 ( < 15mm) stents were implanted. There were 45 SSI stents (the whole stent was in the vertebral lumen) , 113 SS2 stents (1/3 of the stent length extended to the proximal end of vertebral artery origin) ,and 34 SS3 stents (1/2 of the stent length extended to the proximal end of vertebral artery origin). There were 66 drug-eluting stents and 126 metal bare stents. ②Within 1 week after stenting,the diameters at the vertebral artery origin were significantly enlarged than those before stenting (2.7 ±0.6 mm vs. 1.1 ±0.3 mm). PSV and EDV improved significantly compared to before procedure,they were 317 + 109 cm/s vs. 123 ±49cm/s and 102 ±54 cm/s vs. 33 ± 15 cm/s respectively. ③The detection rate of residual stenosis after procedure was 22.4% (43/192). There were no significant differences in the incidences of residual stenosis among the durg-eluting stents ( 18. 2% ) , metal bare stents (24. 6% ) and the different length stent groups (P > 0. 05 ). The incidence of residual stenosis (15. 9% ) in patients treated with the SS2 stents was significantly lower than that of SSI stents (31.1%) and SS3 stents (32.4%). Conclusion Stenting may improve the stenotic lumen and hemodynamics. The site of stent is an independent risk factor for residual stenosis after procedure.关键词
椎动脉狭窄/支架/超声检查,多普勒,彩色/残余狭窄Key words
Vertebral artery stenosis/ Stents/ Ultrosonography,Doppler,color/ Residual stenosis引用本文复制引用
李景植,华扬,贾凌云,刘蓓蓓,刘玉梅,段春,王力力,周瑛华..超声评估椎动脉起始段支架置入后残余狭窄及支架位置对其的影响[J].中国脑血管病杂志,2012,9(11):577-580,4.基金项目
国家自然科学基金资助项目(81070924) （81070924）
