椎动脉起始部狭窄支架置入术后再狭窄的影响因素分析

目的观察椎动脉起始部粥样硬化性狭窄支架置入术(VAOASS)后再狭窄发生率及其影响因素。方法纳入2006年1月~2013年3月在空军总医院行VAOASS的患者共78例(80枚支架),分为再狭窄组29例和无再狭窄组49例。采用数字减影血管造影及CT血管造影评估患者术后6个月后支架内再狭窄情况,分析VAOASS后再狭窄发生的影响因素。结果 VAOASS后再狭窄29例,发生率为37.18%,再狭窄组与无再狭窄组在年龄、性别、随访时间、高血压、糖尿病、高胆固醇血症、狭窄侧别、狭窄率、残余狭窄率和狭窄长度等比较,差异无统计学意义(P>0.05),再狭窄组吸烟率明显高于无再狭窄组(62.52%vs 38.78%,P=0.022);再狭窄组椎动脉原始内径明显小于无再狭窄组[(3.22±0.58)mmvs(3.65±0.38)mm,P=0.000];多因素logistic回归分析显示,吸烟(OR=3.833,95%CI:1.042~14.095,P=0.043)和椎动脉原始内径(OR=6.008,95%CI:1.644~21.959,P=0.007)是支架内再狭窄的独立影响因素。结论 VAOASS后再狭窄率偏高,吸烟及椎动脉原始内径是支架内再狭窄的独立影响因素。

Influencing factors for restenosis after vertebral artery origin atherosclerotic stenosis stenting

Objective To observe the incidence of restenosis after vertebral artery origin atherosclerotic stenosis stenting(VAOASS)and its influencing factors.Methods Seventy-eight patients(80stents)who underwent VAOASS in our hospital from January 2006 to March 2013 were divided into restenosis group(n=29)and non-restenosis group(n=49).Their in stent restenosis was assessed by digital subtraction angiography and CT angiography 6 months after VAOASS.Influencing factors for restenosis after VAOASS were analyzed.Results Restenosis occurred in29(37.18%)out of the 78 patients after VAOASS.No significant difference was found in age,gender,follow-up time,and incidence of hypertension,diabestes mellitus,hypercholesterolemia,stenosis,residual stenosis,and length of stenosis between the restenosis group and non-restenosis group(P>0.05).The smoking rate was significantly higher and the vascular diameter was significantly shorter in restenosis group than in non-restenosis group(62.52%vs 38.78%,P=0.022;3.22±0.58 mmvs 3.65±0.38 mm,P=0.000).Multivariate logistic regression analysis showed that smoking and vascular diameter were the independent influencing factors for restenosis(OR=3.833,95%CI:1.042-14.095,P=0.043;OR=6.008,95%CI:1.644-21.959,P=0.007).Conclusion The incidence of restenosis is high after VAOASS.Smoking and vascular diameter are the independent influencing factors for restenosis.