球囊扩张支架治疗症状性大脑中动脉狭窄的疗效观察及1年随访研究

目的观察球囊扩张支架治疗症状性大脑中动脉狭窄的疗效观察及1年随访研究。方法回顾分析我院自2009年7月至2011年2月应用球囊扩张支架治疗经抗血小板治疗无效的症状性大脑中动脉狭窄患者68例,共77处病变,狭窄程度≥50%,研究围手术期并发症及术后1年随访。结果 68例患者置入支架73枚,12例重度狭窄者使用2 mm冠脉球囊预扩,手术成功率为94.1%,术后造影即刻狭窄程度为(5.9±7.8)%,与术前(74.4±8.4)%明显改善,围手术期并发症发生率4.7%,术后同侧血管年卒中率3.1%,无死亡事件发生。1年随访再狭窄率为7.8%,其中2例系症状性狭窄。结论球囊扩张支架治疗症状性大脑中动脉狭窄有较好的安全性和临床疗效,长期疗效还需要进一步建立长期的大样本多中心的随机对照研究。

Treatment of symptomatic atherosclerotic middle cerebral artery stenosis with balloon-expandable stent and one year follow-up study

Objective To observe the safety and feasibility of balloon-expandable stent(Appolo stent) in treating symptomatic atherosclerotic middle cerebral artery(MCA) stenosis and one year follow-up study.Methods From July 2009 to February 2011,68 patients with symptomatic MCA stenosis ≥50% received stenting if they had recurred ischemia stroke while receiving antiplatelet therapy.The clinical results of perioperative complications and a year follow-up were reviewed and analyzed.Results 64 of 68 cases were successfully treated with 73 balloon-expandable stent,the stent successful rate was 94.1%,the degree of stenosis was reduced from a baseline of(74.4±8.4)% to(5.9±7.8)% after stenting.Perioperative complications rate was 4.7%.5 cases re-stenosis occurred after a year of stenting,during a year follow-up,the annual stroke rate in the ipsilateral MCA territory was 3.1%,and there were no deaths occurred.Conclusion Angioplasty and stenting with balloon-expandable stent(Appolo stent) are feasible and effective for treaing of symptomatic atherosclerotic MCA stenosis.Further randomized,controlled studies with large samples are needed in order to clasfy its long-term effect.