摘要
目的探讨药物涂层球囊(DCB)在治疗症状性颅内动脉粥样硬化性狭窄中的安全性及有效性。方法回顾性分析2018年9月至2020年5月北京医院神经外科收治的48例症状性颅内动脉粥样硬化性狭窄患者的临床资料。所有患者均采用DCB行经皮腔内血管成形术。通过影像学随访评估术后再狭窄情况,动脉狭窄程度>50%定义为再狭窄。临床随访观察患者有无再发责任血管区域缺血事件发生。所有患者根据动脉狭窄部位分为前循环组(30例)和后循环组(1$例),比较两组在一-般资料.围手术期并发症、随访期卒中发生率及再狭窄率等方面的差异。结果48例患者共51处颅内动脉狭窄采用DCB进行治疗;DCB的到位率为98.0%(50/51),术后残余狭窄程度的中位数(四分位数间距)为22.5%(25.0%),与术前的狭窄程度[80.0%(20.0%)]相比,差异有统计学意义(Z=-8.745,P<0.001)。围手术期发生卒中2例(4.2%),无死亡患者。46例患者的影像学随访时间[中位数(四分位数间距)]为5.5(5.0)个月,动脉再狭窄的发生率为4.3%(2/46),症状性再狭窄的发生率为2.2%(1/46);48例患者均行临床随访,随访时间[中位数(四分位数间距)]为8.0(6.0)个月,发生缺血性并发症2例(4.2%),包括责任血管供血区域的卒中或短暂性脑缺血发作各1例。前、后循环组在围手术期并发症、随访期卒中发生率及再狭窄率上的差异均无统计学意义(均P>0.05)。结论对于症状性颅内动脉粥样硬化性狭窄患者,无论病变位于前、后循环,采用DCB行血管成形术均相对安全,且近期疗效满意。
Objective To explore the safety and efficacy of drug-coated balloon(DCB)angioplasty in the treatment of symptomatic intracranial atherosclerotic stenosis(ICAS).Methods A retrospective analysis was conducted on the clinical data of 48 patients with symptomatic ICAS admitted to Department of Neurosurgery of Beijing Hospital from September 2018 to May 2020.All patients underwent percutaneous transluminal angioplasty(PTA)with DCB.The postoperative restenosis was evaluated by imaging follow-up,and the degree of arterial stenosis>50%was defined as restenosis.Clinical follow-up was conducted to observe whether the patient had recurrence of ischemic events in the area related to the corresponding artery.All patients were divided into anterior circulation group(30 cases)and posterior circulation group(18 cases)according to the location of arterial stenosis.The differences in general information,perioperative complications,stroke incidence and restenosis rate during follow-up were compared between the two groups.Results A total of 51 lesions of intracranial artery stenosis in 48 patients were treated with DCB.The in-place success rate of DCB was 98.0%(50/51).The median postoperative residual stenosis rate(interquartile range)was 22.5%(25.0%),which was significantly different from the preoperative stenosis rate(interquartile range)[80.0%(20.0%)](Z=-8.745,P<0.001).There were 2 cases of stroke(4.2%)during the perioperative period,and no patients died.Forty-six patients underwent imaging follow-up for 5.5(5.0)months,the incidence of arterial restenosis was 4.3%(2/46),and the incidence of symptomatic restenosis was 2.2%(1/46).All 48 patients underwent clinical follow-up which lasted for 8.0(6.0)months,and 2 cases(4.2%)developed ischemic complications,including 1 case of stroke caused by the corresponding artery and 1 case of transient ischemic attack.The anterior and posterior circulation groups had no statistically significant differences in perioperative complications,stroke incidence or restenosis rate during follow-up(all P
作者
杨希孟
陆军
祁鹏
王俊杰
胡深
陈鲲鹏
王大明
Yang Ximeng;Lu Jun;Qi Peng;Wang Junjie;Hu Shen;Chen Kunpeng;Wang Daming(Department of Neurosurgery,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)
出处
《中华神经外科杂志》
CSCD
北大核心
2021年第6期551-556,共6页
Chinese Journal of Neurosurgery
基金
北京医院临床研究121工程资助项目(BJ-2018-086)。
关键词
颅内动脉硬化
血管内手术:治疗结果
颅内动脉狭窄
药物涂层球囊
Intracranial arteriosclerosis
Endovascular procedures
Treatment outcome
Intracranial stenosis
Drug-coated balloon
