Wingspan支架治疗症状性颅内动脉狭窄术后再狭窄的相关因素分析

目的 分析症状性颅内动脉狭窄Wingspan支架置人术后再狭窄的相关因素.方法 在南京卒中注册系统中选取2007年1月至2009年12月间成功置入Wingspan支架的症状性颅内动脉粥样硬化性狭窄患者42例,并进行随访观察和分析.根据影像学随访结果将患者分为无再狭窄组和再狭窄组.再狭窄定义为支架内或支架两侧5 mm范围内狭窄程度＞50%或血管直径较支架置人时减少＞20%.采用多因素Cox回归分析筛选出支架内再狭窄的独立风险因素.结果 影像学随访中位数时间为7(4～23)个月.42例患者(43个病变)中,有15例(35.7%)患者(16个病变,37.2%)发生再狭窄.多因素Cox回归分析显示糖尿病风险比(HR)=0.281,95%可信区间(CI)=0.088～0.898,P=0.032]和支架直径(HR=0.213,95%CI=0.049～0.918,P=0.038)与Wingspan支架置入术后再狭窄相关.结论 糖尿病和支架直径是症状性颅内动脉狭窄Wingspan支架置入术后再狭窄的独立风险因素.

Abstract：

Objective To analyze the predictors of Wingspan in-stent restenosis(ISR)for the treatment of symptomatic intracranial arterial stenosis.Methods Between January 2007 and November 2009,42 patients with symptomatic intracranial arterial stenosis registered in Nanjing stroke registry program (NSRP)were treated with Wingspan stent system.Clinical and follow-up results were retrospectively analyzed.They were divided into the non-restenosis and restenosis groups according to their follow-up imaging data.ISR was defined as＞50% stenosis within 5 mm or adjacent to stent or an absolute luminal loss＞20% The analysis of stepwise multivariate Cox regression was performed to evaluate the independent predictive flactors.Results ISR was found in 15 patients(15/42,35.7%) with 16 lesions(16/43,37.2%)at a median follow-up period of 7 months(range:4-23).Diabetes(HR=0.281;95% CI=0.088-0.898;P=0.032)and stent diameter(HR=0.213;95% CI=0.049-0.918;P=0.038)were two independent Dredictors for ISR.Conclusion Diabetes and stent diameter may be two independent predictors for ISR after a treatment of Wingspan system.

Predictors of Wingspan in-stent restenosis for the treatment of symptomatic intracranial arterial stenosis

Objective To analyze the predictors of Wingspan in-stent restenosis(ISR)for the treatment of symptomatic intracranial arterial stenosis.Methods Between January 2007 and November 2009,42 patients with symptomatic intracranial arterial stenosis registered in Nanjing stroke registry program (NSRP)were treated with Wingspan stent system.Clinical and follow-up results were retrospectively analyzed.They were divided into the non-restenosis and restenosis groups according to their follow-up imaging data.ISR was defined as＞50% stenosis within 5 mm or adjacent to stent or an absolute luminal loss＞20% The analysis of stepwise multivariate Cox regression was performed to evaluate the independent predictive flactors.Results ISR was found in 15 patients(15/42,35.7%) with 16 lesions(16/43,37.2%)at a median follow-up period of 7 months(range:4-23).Diabetes(HR=0.281;95% CI=0.088-0.898;P=0.032)and stent diameter(HR=0.213;95% CI=0.049-0.918;P=0.038)were two independent Dredictors for ISR.Conclusion Diabetes and stent diameter may be two independent predictors for ISR after a treatment of Wingspan system.