症状性椎动脉开口处狭窄支架成形术后再狭窄的影响因素分析

目的探讨症状性椎动脉开口处狭窄支架成形术后再狭窄的影响因素。方法收集2010年1月~2015年5月在南京医科大学附属淮安医院住院治疗症状性椎动脉开口处支架成形术的患者的所有临床资料。采用DSA或CTA评估患者术后半年时再狭窄情况,分析再狭窄发生的危险因素。结果 44例资料完整的患者被纳入分析,其中共有11例(25%)患者发生支架术后再狭窄,但发生症状性再狭窄需要再次治疗仅1例。再狭窄组与无再狭窄组性别、年龄、饮酒、高血压、糖尿病、高脂血症、狭窄侧别(左侧、右侧)、术前狭窄率、残余狭窄率和狭窄部位长度、随访时间、支架品牌等比较,差异无统计学意义(均P0.05)。再狭窄组吸烟的比例(54.5%)明显高于无再狭窄组(18.2%)(P=0.045);再狭窄组狭窄处远端正常椎动脉直径[(3.1±0.4)mm]明显小于无再狭窄组[(3.8±0.5)mm](P0.001)。多因素Logistic回归分析显示,吸烟和椎动脉直径是支架成形术后再狭窄的独立影响因素(均P0.05)。结论症状性椎动脉开口处狭窄支架成形术后再狭窄与吸烟和椎动脉直径密切相关。

Analysis of influence factors of restenosis after stenting of vertebral artery origin symptomatic stenosis

Objective To investigate the influence factors of restenosis after stenting of vertebral artery origin symptomatic stenosis.Methods All clinical data of patients with symptomatic vertebral artery origin stenosis treated with stents were collected during the January 2010 to May 2015 in Huai'an Hospital Affiliated to Nanjing Medical University.The stent restenosis was assessed by digital subtraction angiography or CT angiography 6 months after stenting.Influencing factors of the restenosis in stent were analyzed.Results A total of 44 patients with complete data were included.Among them, 11 patients ( 25%) with stent restenosis occurred.However, only one patient experienced symptomatic restenosis and needed treatment.No significant difference was found in gender, age, drinking, hypertension, diabetes mellitus, hyperlipidemia, side-of-stenosis, the rate of preoperative stenosis, residual stenosis, length of stenosis , follow-up time and stent brand between the restenosis group and non-restenosis group(all P>0.05).The smoking rate was significantly higher and the vascular diameter was significantly shorter in restenosis group [54.5%, (3.1 ±0.4) mm] than in non-restenosis group [18.2%,(3.8 ±0.5) mm] ( P=0.045;P<0.001 ) .Multiple Logistic regression analysis showed that smoking and vertebral artery diameter were independent risk factors of restenosis after stenting ( all P<0.05 ) .Conclusion The restenosis of vertebral artery origin stenosis after stent angioplasty is closely related to smoking and vertebral artery diameter.