[1]张学贤,杨 凯,冯超凡,等.颅内动脉瘤支架植入术后新生内膜增生临床研究[J].介入放射学杂志,2022,31(04):328-332.
 ZHANG Xuexian,YANG Kai,FENG Chaofan,et al.Clinical study of neointimal hyperplasia after stent implantation for intracranial aneurysms[J].journal interventional radiology,2022,31(04):328-332.
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颅内动脉瘤支架植入术后新生内膜增生临床研究()

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

卷:
31
期数:
2022年04
页码:
328-332
栏目:
神经介入
出版日期:
2022-06-15

文章信息/Info

Title:
Clinical study of neointimal hyperplasia after stent implantation for intracranial aneurysms
作者:
张学贤 杨 凯 冯超凡 万 程 赵 卫 胡继红 孟雪柔 李自恒
Author(s):
ZHANG Xuexian YANG Kai FENG Chaofan WAN Cheng ZHAO Wei HU Jihong MENG Xuerou LI Ziheng.
Department of Medical Imaging, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China
关键词:
【关键词】 颅内动脉瘤 支架 新生内膜增生
文献标志码:
A
摘要:
【摘要】 目的 探讨颅内动脉瘤支架植入术后新生内膜增生(NIH)变化及其影响因素。方法 收集2018年10月至2020年10月在昆明医科大学第一附属医院接受支架辅助弹簧圈栓塞(SACE)或血流导向装置(FD)治疗的42例颅内前循环动脉瘤患者临床资料。分析治疗后支架NIH状况及影响因素。两名高年资神经介入医师根据血管造影图像,测量并记录患者术后即刻、术后随访复查时支架段最狭窄处、颈内动脉岩段直径,并计算每幅图像比率(T值,支架段直径/岩段颈内动脉直径)。 结果 T值变化呈由大至小再由小变大的动态过程,远期随访10~15个月(中位12.5个月)T值已基本恢复至术后即刻水平。单因素分析结果显示年龄、动脉瘤长径是患者中期NIH的影响因素。多因素logistic回归分析显示年龄是中期NIH发生的预测因子(OR=0.903,95%CI=0.828~0.984,P=0.020),患者年龄越大治疗后出现NIH的可能性越小。结论 颅内动脉瘤支架植入术后NIH变化是一逐渐加重、逐渐减轻的动态过程,远期随访时支架段血管直径基本恢复至术后即刻水平。年龄、动脉瘤大小是患者中期NIH影响因素,年龄是独立保护因素。

参考文献/References:

[1] Kim YS, Lee SW, Yeom JA, et al. Angiographic findings of in-stent intimal hyperplasia after stent- assisted coil embolization: are they permanent findings?[J]. J Neurosurg, 2016, 124: 328-333.
[2] Wakhloo AK, Gounis MJ. Revolution in aneurysm treatment: flow diversion to cure aneurysms: a paradigm shift[J]. Neurosurgery, 2014, 61(Suppl 1): 111-120.
[3] John S, Bain MD, Hui FK, et al. Long- term follow- up of in- stent stenosis after pipeline flow diversion treatment of intracranial aneurysms[J]. Neurosurgery, 2016, 78: 862-867.
[4] 《药学与临床研究》编辑部. 如何正确运用组内相关系数进行一致性检验——药物研究中的统计学(一) [J]. 药学与临床研究, 2018, 26:7-8.
[5] 蒋业清,鲁 刚,葛 亮,等. 颅内动脉瘤介入治疗相关症状性缺血并发症分析[J]. 介入放射学杂志, 2021, 30:112-117.
[6] Kuhn AL, Kan P, Srinivasan V, et al. Flow diverter for endovascular treatment of intracranial nirror segment internal carotid artery aneurysms[J]. Interv Neuroradiol, 2019, 25: 4-11.
[7] Kuhn AL, Hou SY, Perras M, et al. Flow diverter stents for unrup- tured saccular anterior circulation perforating artery aneurysms: safety, efficacy, and short- term follow- up[J]. J Neurointerv Surg, 2015, 7: 634- 640.
[8] Guzzardi G, Stanca C, Cerini P, et al. Long- term follow- up in the endovascular treatment of intracranial aneurysms with flow-diverter stents: update of a single- centre experience[J]. Radiol Med, 2018, 123: 449-455.
[9] 嵇再雄,李家祺,王建波. 酸枣仁皂苷B通过调节自噬抑制血小板衍生生长因子-BB诱导的血管平滑肌细胞增殖和迁移[J]. 介入放射学杂志, 2021, 30:149-152.
[10] Cohen JE, Gomori JM, Moscovici S, et al. Delayed complications after flow- diverter stenting: reactive in- stent stenosis and creeping stents[J]. J Clin Neurosci, 2014, 21: 1116-1122.
[11] Caroff J, Iacobucci M, Rouchaud A, et al. The occurrence of neointimal hyperplasia after flow- diverter implantation is associated with cardiovascular risks factors and the stent design[J]. J Neurointerv Surg, 2019, 11: 610- 613.
[12] Thomas AJ, Ogilvy CS. Flow diversion for intracranial aneurysm treatment[J]. Neurosurgery, 2020, 86(Suppl 1): S1-S2.
[13] Chalouhi N, Daou B, Kung D, et al. Fate of the ophthalmic artery after treatment with the pipeline embolization device[J]. Neurosurgery, 2015, 77: 581-584.
[14] Feng X, Qian Z, Liu P, et al. Comparison of recanalization and in- stent stenosis between the low- profile visualized intraluminal support stent and enterprise stent-assisted coiling for 254 intracranial aneurysms[J]. World Neurosurg, 2018, 109: e99- e104.
[15] Sindeev S, Prothmann S, Frolov S, et al. Intimal hyperplasia after aneurysm treatment by flow diversion[J]. World Neurosurg, 2019, 122: e577- e583.

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备注/Memo

备注/Memo:
(收稿日期:2021- 05- 08)
(本文编辑:边 佶)
更新日期/Last Update: 2022-05-11