摘要
目的探讨不同类型支架治疗大脑中动脉狭窄病变的临床效果和影像学结果。方法选择大脑中动脉M1段狭窄病变的患者67例,根据置入的支架不同,将患者分为3组:Invastent组21例,影像学检查平均随访18.6个月;Apollo组1 7例,影像学检查平均随访19.5个月;Wingspan组29例,影像学检查平均随访1 5.1个月,对3组临床事件和影像学结果进行COX分析。结果 67例患者共置入69枚支架,Invastent组、Apollo组和Wingspan组支架置入成功率分别为95.8%、100%和96.7%(P>0.05)。Invastent组缺血性脑卒中和(或)死亡发生率15.8%,Apo1lo组为6.3%,Wingspan组为10.3%,3组比较差异无统计学意义(P>0.05)。影像学随访Wingspan组再狭窄率虽高于Invastent组和Apollo组(33.0 % vs 15.8%.12.5%),但差异无统计学意义(P>0.05)。Wingspan支架是术后再狭窄的危险因素(HR=4.37,95% CI:1.02～18.78,P=0.047)。结论与球囊扩张式支架置入比较,Wingspan支架是术后再狭窄的危险因素,其与临床预后无关,但需进一步研究证实。
Objective To investigate clinical efficacy and angiographic outcomes of different stents in treatment of the stenosis of middle cerebral artery. Methods The data of 67 patients undergoing single stent placement in the M1 segment of middle cerebral artery were retrieved. According to the type of stent implanted,the patients were divided into three groups：21 patients in Ivastent group, 17 in Apollo group, and 29 in Wingspan group. Average image follow-up time was 16. 6 months. COX regression model was used to analyze the clinical and angiographic outcomes. Results A total of 69 stents were implanted for 67 patients. The rates of successful stent implantation in Invastent group,Apollo group and Wingspan group were 95.8%, 100% and 96. 7% respectively （P 〉 0.05）. The incidence of ischemie stroke and（or） death was 15.8%in Invastent group, 6.3% in Apollo group and 10.3% in Wingspan group, and there was no statistically significant difference among the three groups （P 〉 0.05）. Although there was no statistical significance,the incidence of restenosis after stent deployment in Wingspan group was higher than that of the Invastent group and Apollo group（33.0% vs 15.8% and 12.5%, P 〉0.05）. Wingspan stent was a risk factor for restenosis by multivariate Cox regression model analysis （HR = 4. 37,95% CI： 1.02-18.78, P = 0. 047）. Conclusion Wingspan stent is a risk factor for restenosis after stent placement, but it is not related to the clinical outcomes. The findings should be confirmed further by multi-center,large sample size studies.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2010年第10期888-891,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(30870847)
江苏省自然科学基金(BK2008324)
关键词
大脑中动脉
脑血管障碍
支架
血管成形术
气囊
middle cerebral artery
cerebrovaseular disorders
stents
angioplasty, balloon
