不同材料支架置入后颅内靶血管再狭窄的影像形态学评估

目的：比较不同材料支架置入后颅内靶血管再狭窄影像形态学差异。方法：选择2003-05/2007-05在中国医科大学附属第四医院住院的颅内动脉狭窄患者182例，按置入支架材料的类型分组：金属裸支架组74例(98支)，药物涂层支架组108例(37支)。两组患者分别于颅内动脉狭窄部位置入金属裸支架/药物涂层支架，随访15个月。采用全脑数字减影血管造影，观察随访期间靶血管再狭窄形态学变化。结果：与金属裸支架组比较，药物涂层支架组靶血管再狭窄发生率明显降低(P < 0.05)，支架内弥漫性再狭窄、超过支架边缘的弥漫增殖性病变明显减少，支架内局限性再狭窄和支架近端局限性再狭窄明显增多(P < 0.05或0.01)。结论：金属裸支架置入处再狭窄发生率高，影像形态学以支架内弥漫和支架内弥漫累及两端为主；药物涂层支架再狭窄率低，影像形态学以支架内局限和支架近端局限多见。

Morphological evaluation of intracranial target vessel restenosis following various stent implantations

OBJECTIVE: To compare morphological differences of intracranial target vessel restenosis following various stent implantations.METHODS: 182 patients with intracranial arteriostenosis were selected from the Fourth Hospitals of China Medical University between May 2003 and May 2007, and divided into bare stent group (n=74, 98 stents) and drug stent group (n=108, 137 stents). All patients were followed up for 15 months, and underwent digital subtraction angiography to evaluate morphological changes of target vessel restenosis.RESULTS: Compared with bare stent group, the restenosis rates were significantly reduced in drug-eluting stent group (P < 0.05), the incidence of suffusion proliferation diseases reduced but intra-stent limitation and proximal stent limitation significantly increased (P < 0.05 or 0.01).CONCLUSION: Incidence of restenosis is high following bare-mental stent implantation, and morphological images mainly exhibit intra-stent suffusion and intra-stent involved suffusion. While, incidence of restenosis is low following drug stent implantation, and morphological images mainly exhibit intra-stent limitation and proximal stent limitation.