[1]晋永强,戴 健,陈国栋,等.雷帕霉素洗脱椎动脉支架治疗重度椎动脉起始部狭窄的临床效果观察[J].介入放射学杂志,2024,33(03):275-279.
 JIN Yongqiang,DAI Jian,CHEN Guodong,et al.Clinical efficacy of rapamycin-eluting vertebral artery stents in the treatment of severe ostial vertebral artery stenosis[J].journal interventional radiology,2024,33(03):275-279.
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雷帕霉素洗脱椎动脉支架治疗重度椎动脉起始部狭窄的临床效果观察()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
33
期数:
2024年03
页码:
275-279
栏目:
临床研究
出版日期:
2024-03-27

文章信息/Info

Title:
Clinical efficacy of rapamycin-eluting vertebral artery stents in the treatment of severe ostial vertebral artery stenosis
作者:
晋永强 戴 健 陈国栋 江学伟 刘 超 汤璐璐
Author(s):
JIN Yongqiang DAI Jian CHEN Guodong JIANG Xuewei LIU Chao TANG Lulu.
Maanshan General Hospital of Ranger-Duree Healthcare, Maanshan, Anhui Province 243000, China
关键词:
【关键词】 椎动脉狭窄 雷帕霉素 药物洗脱支架 支架内再狭窄
文献标志码:
A
摘要:
【摘要】 目的 探讨雷帕霉素药物洗脱椎动脉支架治疗重度椎动脉起始部狭窄(OVAS)的临床效果及术后支架内再狭窄率。方法 回顾性选取2020年11月至2022年5月于我院就诊行支架成形手术治疗的重度OVAS患者共96例,包括观察组(48例)和对照组(48例),观察组给予植入雷帕霉素洗脱椎动脉支架,对照组给予植入外周球囊扩张金属裸支架,观察对比围手术期基本情况、随访期间并发症发生情况和术后支架内再狭窄率。结果 两组患者均成功植入支架,围手术期均未发生短暂性脑缺血发作(TIA)、支架脱落或断裂、椎动脉或支架相关脑卒中等并发症。两组患者手术植入的支架长度及支架管径均无明显差异(P>0.05),两组患者术前血管狭窄率及术后血管残余狭窄率差异均不显著(P>0.05),术后两组患者的残余狭窄率均小于20%。术后随访患者(12.33±5.82)个月,观察组和对照组患者椎动脉或支架相关的脑卒中发生率分别为0%和4.17%,无明显差异(P>0.05)。观察组47例和对照组45例患者头晕、眩晕等症状均较前改善,均未再发后循环TIA,均未发现支架相关血栓事件。观察组患者的支架植入术后再狭窄发生率(10.42%)明显低于对照组(29.17%,P<0.05)。结论 雷帕霉素洗脱椎动脉支架能安全有效地治疗重度OVAS,且能减少术后支架内再狭窄率。

参考文献/References:

[1] Gulli G, Marquardt L, Rothwell PM, et al. Stroke risk after posterior circulation stroke/transient ischemic attack and its relationship to site of vertebrobasilar stenosis: pooled data analysis from prospective studies[J]. Stroke, 2013, 44: 598- 604.
[2] Thompson MC, Issa MA, Lazzaro MA, et al. The natural history of vertebral artery origin stenosis[J]. J Stroke Cerebrovasc Dis, 2014, 23: e1- e4.
[3] Kohta M, Fujita A, Yamashita S, et al. Ultrasonographically- guided stent placement at the vertebral artery origin without contrast medium: a case report[J]. J Clin Ultrasound, 2020, 48: 362- 366.
[4] 夏金超, 汪勇锋, 许岗勤, 等. 不同类型支架治疗椎动脉开口狭窄的对照研究[J]. 介入放射学杂志, 2020, 29: 136- 139.
[5] Tank VH, Ghosh R, Gupta V, et al. Drug eluting stents versus bare metal stents for the treatment of extracranial vertebral artery disease: a meta- analysis[J]. J Neurointerv Surg, 2016, 8: 770- 774.
[6] Langwieser N, Buyer D, Schuster T, et al. Bare metal vs. drug- eluting stents for extracranial vertebral artery disease: a meta- analysis of nonrandomized comparative studies[J]. J Endovasc Ther, 2014, 21: 683- 692.
[7] Maciejewski DR, Pieniazek P, Tekieli L, et al. Comparison of drug- eluting and bare metal stents for extracranial vertebral artery stenting[J]. Postepy Kardiol Interwencyjnej, 2019, 15: 328- 337.
[8] Barnett HJM, Taylor DW, Haynes RB, et al. Beneficial effect of carotid endarterectomy in symptomatic patients with high- grade carotid stenosis[J]. N Engl J Med, 1991, 325: 445- 453.
[9] Stayman AN, Nogueira RG, Gupta R. A systematic review of stenting and angioplasty of symptomatic extracranial vertebral artery stenosis[J]. Stroke, 2011, 42: 2212- 2216.
[10] Marquardt L, Kuker W, Chandratheva A, et al. Incidence and prognosis of>or = 50% symptomatic vertebral or basilar artery stenosis: prospective population- based study[J]. Brain, 2009, 132: 982- 988.
[11] Markus HS, Larsson SC, Kuker W, et al. Stenting for symptomatic vertebral artery stenosis: the vertebral artery ischaemia stenting Trial[J]. Neurology, 2017, 89: 1229-1236.
[12] Jiang Y, Xu X, Wen Z, et al. In- stent restenosis after vertebral artery stenting[J]. Int J Cardiol, 2015, 187: 430- 433.
[13] Li J,Hua Y,Needleman L,et al. Arterial occlusions increase the risk of in- stent restenosis after vertebral artery ostium stenting[J]. J Neurointerv Surg, 2019, 11: 574- 578.
[14] 黄志志, 廖 宝, 梁 柯, 等. 国产雷帕霉素洗脱支架治疗椎动脉狭窄临床研究[J]. 介入放射学杂志, 2020, 29: 1072- 1074.
[15] Ma G, Song L, Ma N, et al. Safety and efficacy of rapamycin- eluting vertebral stents in patients with symptomatic extracranial vertebral artery stenosis[J]. Front Neurol, 2021, 12: 649426.
[16] 张 琳, 张瑞岩, 朱政斌, 等. 国产雷帕霉素洗脱支架和裸支架植入后血管再内皮化实验研究[J]. 介入放射学杂志, 2009, 18: 616- 619.

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备注/Memo

备注/Memo:
(收稿日期:2023- 03- 21)
(本文编辑:茹 实)
更新日期/Last Update: 2024-03-27