镍钛合金材料自膨胀式Wingspan支架置入症状性颅内动脉狭窄血管13例1年随访

背景：Gateway-WingSpan支架系统是2005年通过美国FDA认证，用于治疗症状性颅内动脉狭窄的镍钛合金自膨胀式支架，2007年在中国获得批准正式应用。目的：进一步验证镍钛合金材料自膨胀式Wingspan支架置入治疗症状性脑动脉狭窄的近期疗效及安全性。方法：对13例症状性脑动脉狭窄患者在Gateway球囊预扩下行Wingspan支架置入，狭窄病变18处，其中颈内动脉海绵窦段狭窄4处，大脑中动脉水平段狭窄11处，椎动脉末段狭窄2处，基底动脉下段狭窄1处。狭窄长度5~15 mm，平均狭窄(85.3±10.0)%。结果与结论：支架置入成功率100%，置入后即刻造影显示残余狭窄在(30.5±12.0)%；随访12个月，未发生新发卒中或短暂性脑缺血发作，影像学检查显示均无再狭窄发生。13例均未出现与支架有关的动脉夹层、动脉内膜撕裂及急性支架内血栓形成等。均无支架的移位、断裂。支架置入后3 d内出现低血压 1例，皮下血肿1例，经治疗后症状均消失。结果显示镍钛合金材料自膨胀式Wingspan支架置入治疗症状性脑动脉狭窄比较安全，短期疗效较好。

Nickel-titanium alloy self-expanding Wingspan stent in treatment of intracranial symptomic artery stenosis: One-year follow-up of 13 cases

BACKGROUND:Gateway-Wingspan stent system was certified by the U.S. FDA in 2005 as a nickel-titanium alloy self- expanding stent for the treatment of symptomatic artery stenosis, which was approved to be applied formally in China in 2007.OBJECTIVE:To evaluate the safety and short-term effect of endovascular implantation of nickel-titanium alloy self-expanding Wingspan stent for symptomatic artery stenosis. METHODS:Totally 13 patients with 18 lesions diagnosed as symptomatic artery stenosis were treated with endovascular Wingspan stent based on the Gateway saccule self-expansion. The vascular stenotic lesions involved middle cerebral artery in 11 cases, internal carotid artery in 4 cases, vertebral artery in 2 cases, and basilar artery in 1 case. The length of vascular stenotic lesions was 5-15 mm with a mean incidence of (85.3±10.0)%. RESULTS AND CONCLUSION:All of the 18 stents in the 13 patients were placed successfully in one implantation, accounting for 100%. The stenosis residue was (30.5±12.0)% immediately after implantation; after 12 months follow-up, there was no stroke attack or transient cerebral infarction. The vascular angiography showed no stenosis. After stent implantation, there was no arterial dissection, tear of arterial intima, and acute thrombosis in 13 cases. The stents showed no displacement or rupture. One case appeared to have hypotension and one case had ecchymoma within 3 days after stent implantation, and the symptoms disappeared after treatment. The experimental findings demonstrate that endovascular implantation of nickel-titanium alloy self-expanding Wingspan stent is a safe and effective treatment for intracranial symptomatic artery stenosis, with good short-term efficacy.