基底动脉不同部位慢性狭窄血管内支架成形术的临床分析

目的 回顾性分析基底动脉不同部位狭窄的患者行血管内支架成形术的情况,探讨其安全性、可行性及临床疗效.方法 纳入92例经DSA证实的慢性基底动脉重度狭窄(狭窄率≥70%)的患者,评估基底动脉支架成形术的技术成功率、近期临床并发症及中、远期疗效,比较基底动脉中1/3段和下1/3段并发症的发生率,比较球囊扩张支架和Wings...

Clinical analysis of endovascular stenting for different parts of the hasilar artery stenosis

Objectives To analyze endovaseular stenting in patients with basilar artery stenosis at different parts retrospectively and to explore its safety, feasibility, and clinical efficacy. Methods A total of 92 patients with severe stenosis （ ≥70% ） of basilar artery were confirmed by DSA. The technical success rate of basilar artery stenting, short - term clinical complications and long-term efficacy were assessed. The incidence of complications of the middle and lower 1/3 segments of the basilar artery were compared. The incidences of complications after balloon expandable stenting and Wingspan stenting were also compared. Results （1）The technical success rate of stenting was 96.7% （89/92）, the preoperative stenosis rate was 88 ± 6%, and the postoperative stenosis rate was reduced to 16 ± 7%. The differences were statistically significant （ P 〈 0. 01 ）. （2）The incidences of complications at upper, middle and lower 1/3 segments of the basilar artery were 0 （0/3）, 23.8% （5/21）, and 7.4% （5/68）, respectively. The differences were statistically significant （X2 = 3. 190, P 〈 0.05 ）. （3）The incidence of complications after balloon - expandable stenting was 9. 3% （7/75） and after Wingspan stenting was 14. 3% （3/21）. The differences were not statistically significant. （3）A total of 70 patients were followed up for 6 - 47 months, and the mRS scores in 63 patients were ≤〈2. Nine stroke events occurred during the follow-up period and the ineidence was12. 9% （9/70） ; a total of 64 patients received TCD or CTA reexamination, and the incidence of restenosis was 12. 5% （8/64）. Conclusion Endovascular stenting in the treatment of basilar artery stenosis is technically safe and feasible, and the effect is good. The incidence of complications at the middle 1/3 in the basilar artery segment is higher than that at the lower 1/3 segment.