紫杉醇药物涂层球囊血管成形术治疗症状性椎动脉起始处狭窄疗效观察OACSTPCD

Objective To observe the clinical efficacy and safety of paclitaxel drug-coated balloon(P-DCB)plasty for symptomatic vertebral artery origin stenosis(VAOS).Methods The clinical data of 51 patients with symptomatic VAOS treated by P-DCB in the First People's Hospital of Xuzhou from January 2020 to December 2021 were retrospectively analyzed.The degree of stenosis was assessed preoperatively and in the immediate postoperative period,perioperative complications were recorded,neurological function and daily living ability were evaluated using the NIHSS score and the mRS score,and CTA was performed at the time of follow-up to clarify restenosis.Results A total of 51 patients,aged(67.7±9.2)years,who had completed P-DCB treatment were included.The stenosis rate in the immediate postoperative period was(34.0±6.7)%,which was significantly lower than(87.8±8.7)%in the preoperative period,and the difference was statistically significant(P<0.05).One case of vertebral artery entrapment occurred intraoperatively,which was not specifically treated;no death,intracranial hemorrhage,TIA,or stroke related to vertebral artery stenosis occurred in the perioperative period within 30 days.Patients'NIHSS scores and mRS scores were significantly lower postoperative follow-up compared with those preoperative,and the differences were statistically significant(P<0.05).At 6 to 12 months of follow-up,all patients underwent CTA,and the stenosis rate at the beginning of the vertebral artery was(42.3±9.3)%,compared with the stenosis rate in the immediate postoperative period,the difference was statistically significant(P<0.05).A total of 11 cases experienced asymptomatic restenosis,and the incidence of restenosis was 21.6%.Conclusion P-DCB plasty for symptomatic VAOS can effectively relieve patients'symptoms,improve vertebrobasilar artery blood flow,and has low surgical complications.