论文部分内容阅读
目的探讨椎动脉(VA)狭窄患者支架置入术后再狭窄因素及处理方法。方法 70例症状性VA狭窄患者行支架置入术,以彩色多普勒超声(CDI)、CT血管造影(CTA)、数字减影血管造影(DSA)随访支架置入术后的再狭窄率。选择脑血管病危险因素、靶病变长度、残余狭窄、支架位置、钙化斑块等14项观察指标,分析上述各种临床因素与再狭窄的相关性。结果 70例患者置入支架80枚,平均随访时间为(12.5±5.4)个月,CDI随访70例,CTA随访35例,DSA随访23例,14例(14/70,20%)发生再狭窄。术后低密度脂蛋白>2.1 mmol/l、术前狭窄>90%、残余狭窄>20%、椎动脉原始管径<3 mm、狭窄段长度>10 mm及合并钙化、支架突出在锁骨下动脉<1mm与再狭窄显著相关(P<0.05)。年龄>65岁、男性、吸烟史、饮酒史、高血压、糖尿病、冠心病史与支架内再狭窄无关(P>0.05)。3例症状性再狭窄患者行球囊扩张术,效果良好。结论术后低密度脂蛋白>2.1 mmol/l、术前狭窄>90%、残余狭窄>20%、椎动脉原始管径<3 mm、狭窄段长度>10 mm、合并钙化及支架突出在锁骨下动脉<1 mm可能是再狭窄相关因素,出现症状性再狭窄能有效处理。
Objective To investigate the factors and treatment of restenosis after stent implantation in patients with vertebral artery (VA) stenosis. Methods Seventy patients with symptomatic VA stenosis underwent stent implantation. The rate of restenosis after stent implantation was assessed by color Doppler ultrasonography (CDI), computed tomography angiography (CTA) and digital subtraction angiography (DSA). Select the risk factors of cerebrovascular disease, target lesion length, residual stenosis, stent position, calcification plaque and other 14 indicators, analysis of the various clinical factors and restenosis correlation. Results Seventy patients underwent stent placement with an average follow-up of (12.5 ± 5.4) months. Seventy patients were followed up for CDI, 35 were CTA, 23 were DSA, and 14 (70/70) were restenosis . Postoperative low density lipoprotein> 2.1 mmol / l, preoperative stenosis> 90%, residual stenosis> 20%, original diameter of vertebral artery <3 mm, length of stenosis> 10 mm and calcification. The stent was prominent in the subclavian artery <1 mm was significantly associated with restenosis (P <0.05). Age> 65 years old, male, history of smoking, history of drinking, hypertension, diabetes, history of coronary heart disease had no relationship with in-stent restenosis (P> 0.05). 3 patients with symptomatic restenosis underwent balloon dilatation, the effect is good. Conclusions Postoperative low density lipoprotein> 2.1 mmol / l, preoperative stenosis> 90%, residual stenosis> 20%, original diameter of vertebral artery <3 mm, length of stenosis> 10 mm, combined calcification and scaffold under the collarbone Artery <1 mm may be related to restenosis, symptomatic restenosis can be effectively treated.