应用药物洗脱支架治疗椎动脉Wingspan支架内再狭窄

目的探讨应用药物洗脱支架治疗Wingspan支架内再狭窄的可行性和安全性。方法采用Firebird药物洗脱支架对2例Wingspan支架置入术后椎动脉V4段局限性再狭窄（狭窄率〉70％）的患者进行治疗，其中1例为症状性患者，另1例为对侧椎动脉闭塞并且双侧后交通发育不良。将支架缓慢通过再狭窄处，在911．93～1013．25kPa压力下保持15S，释放支架。结果支架均顺利到位并释放，术后即刻造影显示均无明显残余狭窄。手术后患者均无不良反应，术前眩晕反复发作的患者临床症状消失。2例患者均经6个月以上的临床随访，无临床缺血事件发生。1例于支架再置入后6个月复查DSA，显示无明显再狭窄。结论应用药物洗脱支架对Wingspan支架置入术后再狭窄进行再次支架成形术是安全、可行的，病例选择的标准和疗效尚待更大样本的研究。

Drug-eluting stenting for Wingspan in-stent restenosis of vertebral artery

Objective To investigate the feasibility and safety of drug-eluting stenting for Wingspan in-stent restenosis Methods Firebird drug-eluting stenting was used to treat two patients with Wingspan in-stent restenosis （localized restenosis 〉 70% at vertebral artery V4 segment）. One of them was a symptomatic case, and the other had contralateral vertebral artery occlusion and bilateral posterior communica- ting artery hypoplasia. The stents passed through the restenotic site, and they were released under the pres- sure of 911.93 to 1013.25 kPa, maintaining for 15 seconds. Results All the stents were successfully released in place. Angiography showed that there was no significant residual stenosis immediately after the procedure. There was no discomfort in patients after the procedure. The patient＇s preoperative symptom of repeated vertigo attacks was disappeared. No clinical isehemic event occurred in the two patients after following up for more than 6 months. Six months after the restenting, DSA re-examination showed that there was no significant restenosis in one patient. Conclusion Using drug-e]uting stents for in-stent restenosis after Wingspan stenting is technically safe and feasible. However, selection criteria of patients and efficacy of a larger sample study will be needed.