首页|Enterprise支架置入术治疗有症状大脑中动脉粥样硬化狭窄的有效性和安全性

Enterprise支架置入术治疗有症状大脑中动脉粥样硬化狭窄的有效性和安全性

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目的 探讨Enterprise支架置入术治疗有症状大脑中动脉粥样硬化狭窄的有效性和安全性.方法 回顾性纳入2020年1月至2022年12月期间在南京大学医学院附属鼓楼医院神经内科接受Enterprise支架置入术的有症状大脑中动脉粥样硬化狭窄患者.评估残余狭窄程度、围操作期并发症、随访期间支架内再狭窄和卒中复发.结果 共纳入75例患者,男性55例(73.3%),年龄(58±9.7)岁.术前最后一次发作症状为卒中65例(86.7%),短暂性脑缺血发作10例(13.3%).大脑中动脉M1段狭窄67例(89.3%),M2段狭窄8例(10.7%),狭窄程度为88.4%±8.90%.最后一次发作至支架置入的中位时间为18 d(四分位数间距:13~24 d).手术成功率100%,残余狭窄程度为17.3%±6.1%.4例(5.3%)患者发生围操作期并发症,包括3例缺血性卒中和1例有症状颅内出血.61例(81.3%)患者完成3~12个月的随访,其中7例(11.5%)发生支架内再狭窄,2例(3.3%)复发缺血性卒中.结论 Enterprise支架置入术治疗有症状大脑中动脉粥样硬化狭窄可能是安全和有效的.
Efficacy and safety of Enterprise stenting in the treatment of symptomatic middle cerebral artery atherosclerotic stenosis
Objective To investigate the efficacy and safety of Enterprise stenting in the treatment of symptomatic middle cerebral artery atherosclerotic stenosis.Methods Patients with symptomatic middle cerebral artery atherosclerotic stenosis underwent Enterprise stenting in the Department of Neurology,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School from January 2020 to December 2022 were retrospectively included.The degree of residual stenosis,periprocedural complications,in-stent restenosis and stroke recurrence during follow-up were evaluated.Results A total of 75 patients were enrolled,including 55 males(73.3%),aged 58±9.7 years.The last preprocedural symptom was stroke in 65 cases(86.7%)and transient ischemic attack in 10 cases(13.3%).Sixty-seven patients(89.3%)had the Ml segment stenosis of the middle cerebral artery,and 8(10.7%)had the M2 segment stenosis.The degree of stenosis was 88.4%±8.90%.The median time from the last onset to stenting was 18 days(interquartile range,13-24 days).The procedural success rate was 100%,and the residual stenosis degree was 17.3%±6.1%.Four patients(5.3%)experienced periprocedural complications,including three ischemic strokes and one symptomatic intracranial hemorrhage.Sixty-one patients(81.3%)completed 3-to 12-month follow-up,of which 7 patients(11.5%)had in-stent restenosis and 2(3.3%)had recurrent ischemic stroke.Conclusion Enterprise stenting may be safe and effective in the treatment of symptomatic middle cerebral artery stenosis.

Intracranial arteriosclerosisMiddle cerebral arteryIschemic strokeIschemic attack,transientEndovascular proceduresStentsTreatment outcomeRecurrence

张贺、马莉、端光鑫、张曦、张挺正、罗云、徐运、李敬伟

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南京大学医学院附属鼓楼医院神经内科,南京 210008

颅内动脉硬化 大脑中动脉 缺血性卒中 脑缺血发作,短暂性 血管内手术 支架 治疗结果 复发

2024

国际脑血管病杂志
中华医学会,南方医科大学南方医院,海军总医院

国际脑血管病杂志

CSTPCD
影响因子:0.851
ISSN:1673-4165
年,卷(期):2024.32(7)