中国脑血管病杂志2013，Vol.10Issue(7)：342-347,364,7.DOI:10.3969/j.issn.1672-5921.2013.07.003
Wingspan支架治疗重度症状性颅内椎动脉粥样硬化性狭窄的疗效评价
Efficacy evaluation of Wingspan stents for severe symptomatic intracranial vertebral artery atherosclerotic stenosis
摘要
Abstract
Objective To investigate the safety,short-and medium-term efficacy of Wingspan stents in the treatment of severe symptomatic intracranial vertebral artery atherosclerotic stenosis.Methods The clinical and imaging data of 40 consecutive patients with severe intracranial vertebral artery stenosis (42 stenoses) who selected Wingspan stenting due to the failure of medical therapy from April 2007 to February 2013 were analyzed retrospectively.The morphology of vertebral artery stenosis,technical success rate,perioperative complications,and clinical and imaging follow-up results were analyzed.Results ①The technical success rate of stent angioplasty in patients of this group was 100％.The mean stenosis rate decreased from 75.4％ (median [M] range 54.3％ to 99％) to 10.0％ (0 to 40％) after procedure.②All the patients were followed up clinically for 30.5 (M 2 to 72) months,among them 19 were followed up with DSA for a mean of 9 months (range 0.5 to 47),and 14 were followed up with CT angiography or MR angiography for a mean of 8 months (range 2 to 35).Three patients (7.5％) had stroke within 30 days after the procedure,one of them had minor stroke within 24 hours but without disabling,one had embolic event caused disabling stroke within 24 hours,and the other one had subacute in-stent thrombosis caused disabling stroke.One patient (2.5％) suffered minor stroke after day 30 but without disabling.Four patients (12.9％) had restenosis during the follow-up period,3 of them were located in the cranial-entering segments,and 1 had symptomatic restenosis.Conclusion Technical success rate of the Wingspan stents is high in the treatment of severe symptomatic intracranial vertebral artery atherosclerotic stenosis.The treatment is relatively safe,and the short-and medium-term efficacy is good.However,both the residual stenosis rate and restenosis rate are higher in the treatment of stenosis by implanting stents into the cranial-entering segments of vertebral artery.The long-term efficacy remains to be further observed.关键词
椎动脉狭窄/颅内动脉粥样硬化性狭窄/Wingspan支架Key words
Vertebral artery stenosis/Intracranial atherosclerotic stenosis/Wingspan stents引用本文复制引用
杨志刚,田春鸥,张磊,张永巍,贾泽军,黄清海,许奕,赵文元,刘建民..Wingspan支架治疗重度症状性颅内椎动脉粥样硬化性狭窄的疗效评价[J].中国脑血管病杂志,2013,10(7):342-347,364,7.基金项目
国家自然科学基金(30973102) （30973102）
上海市市级医院新兴前沿技术联合攻关项目(SHDC12012103) （SHDC12012103）
长海医院1255学科建设计划(CH125520102) （CH125520102）
