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目的探讨Wingspan支架治疗症状性颅内动脉狭窄的疗效和安全性。方法采用Gateway-Wingspan球囊支架系统治疗症状性颅内动脉狭窄患者90例(92处狭窄部位,93枚支架),观察其手术成功率、症状改善、狭窄率改善及严重不良事件的发生率,术后行脑血管造影术或CTA观察支架内再狭窄发生率。结果支架植入技术成功率98.9%(92/93),患者术前平均狭窄率(83.4±9.5)%,Wingspan支架置入后平均残余狭窄率(21.8±9.8)%。围手术期总并发症6.5%(6/90),病死率3.3(3/90),临床随访1～40(16.7±10.3)个月,30d内任何脑卒中和31d～1年内同侧缺血性卒中的发生率为11.1%(10/90)。30例患者接受了血管造影复查,6个月再狭窄率为16.7%(3/18),平均随访(9.3±6.3)个月的再狭窄率为26.7%(8/30)。结论 Wingspan支架治疗症状性颅内动脉狭窄具有较好的临床疗效和安全性,围手术期总的并发症发生率较低。
Objective To investigate the efficacy and safety of Wingspan stent in treatment of symptomatic intracranial arterial stenosis. Methods Ninety patients (92 sites of stenosis and 93 scaffolds) with symptomatic intracranial arterial stenosis were treated with Gateway-Wingspan balloon stenting system. The success rate, symptom improvement, stenosis rate and the incidence of serious adverse events were observed. Postoperative cerebral angiography or CTA observed stent restenosis. Results The success rate of stent implantation was 98.9% (92/93). The average preoperative stenosis rate was 83.4 ± 9.5%. The average residual stenosis rate was 21.8 ± 9.8% after Wingspan stent implantation. The perioperative complications were 6.5% (6/90), case fatality rate 3.3 (3/90), clinical follow-up 1-40 (16.7 ± 10.3) months, any stroke within 30 days and ipsilateral ischemia within 31 days The incidence of stroke was 11.1% (10/90). Thirty patients underwent angiography, restenosis rate at 6 months was 16.7% (3/18), and mean follow-up (9.3 ± 6.3) months was 26.7% (8/30). Conclusion Wingspan stent treatment of symptomatic intracranial arterial stenosis has good clinical efficacy and safety, perioperative complications lower overall incidence.