摘要
目的评估Enterprise支架治疗老年症状性大脑中动脉狭窄患者的安全性及有效性。方法回顾性分析2013年1月~2015年12月在火箭军总医院神经介入医学科接受Enterprise支架治疗的症状性大脑中动脉重度狭窄,且年龄≥60岁的患者55例,其中男性31例,女性24例,年龄60~81(66.4±8.0)岁。术前及术后给予双联抗血小板聚集药物及强化调脂治疗,采取多模态影像指导下的支架成形术,术后6个月行全脑数字减影血管造影(DSA)明确支架再狭窄情况,观察围术期并发症发生率、支架内再狭窄发生率及靶血管供血区脑卒中复发率。结果手术技术成功率100.0%,术前及术后即刻残留狭窄率(86.6±10.0)%、(29.9±13.2)%。围术期发生1例(1.8%)穿支脑梗死事件,术后随访期有1例脑出血,2例支架内急性闭塞,1例短暂性脑缺血发作事件,术侧大脑中动脉供血区缺血性脑卒中发生率为3.6%。有36例(65.5%)患者接受了DSA复查,血管狭窄率为(34.3±22.8)%,8例(22.2%)患者出现支架内再狭窄。结论 Enterprise支架治疗老年症状性大脑中动脉重度狭窄患者是安全的,且能有效预防供血区脑卒中复发。
Objective To assess the safety and effectiveness of Enterprise stents in treatment of elderly patients with symptomatic middle cerebral artery（MCA）stenosis.Methods Clinical data of 55 elderly patients with symptomatic MCA stenosis who underwent implantation of Enterprise stents in General Hospital of Chinese PLA Rochet Force from January 2013 to December 2015 were retrospectively analyzed.The patients who received dual antiplatelet aggregation drug treatment and intensive lipid-lowering therapy underwent multimodal imaging-guided stenting.Stent restenosis was detected by total cerebral DSA 6months after stenting.The incidence of perioperative complications,stent restenosis and ischemic stroke was recorded.Results The success rate of stenting was 100.0%.The residual stenosis rate was 86.6% ±10.0% and 29.9% ±13.2% respectively before and after stenting.Perioperative perforating infarction,cerebral hemorrhage,acute stent occlusion and TIA were detected in 1,1,2and 1patients respectively.The incidence of ischemic stroke in MCA was 3.6%.DSA showed that the incidence of stenosis and restenosis was 34.3%±22.8% and 22.2%respectively.Conclusion Implantation of Enterprise stents is safe in elderly patients with symptomatic MCA stenosis and can effectively prevent recurrency of ischemic stroke.
作者
邓红亮
赵宇
金旻
刘奇
祥丽
陈洁
杜彬
DENG Hong-liang ZHAO Yu JIN Min et al(Department of Neurology, Kailuan General Hospital, Tangshan 063000, Hebei Province, Chin)
出处
《中华老年心脑血管病杂志》
CAS
2017年第2期130-133,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
基金项目:首都临床特色应用研究与成果推广(Z151100004015207)
关键词
支架
大脑中动脉
血管造影术
数字减影
血小板聚集抑制剂
降血脂药
stents
middle cerebral artery
angiography
digital subtraction
platelet aggregation inhibitors
antilipemic agents
