不同材料支架置入后颅内靶血管再狭窄的影像形态学评估

Morphological evaluation of intracranial target vessel restenosis following various stent implantations

目的:比较不同材料支架置入后颅内靶血管再狭窄影像形态学差异。方法:选择2003-05/2007-05在中国医科大学附属第四医院住院的颅内动脉狭窄患者182例,按置入支架材料的类型分组:金属裸支架组74例(98支),药物涂层支架组108例(37支)。两组患者分别于颅内动脉狭窄部位置入金属裸支架/药物涂层支架,随访15个月。采用全脑数字减影血管造影,观察随访期间靶血管再狭窄形态学变化。结果:与金属裸支架组比较,药物涂层支架组靶血管再狭窄发生率明显降低(P<0.05),支架内弥漫性再狭窄、超过支架边缘的弥漫增殖性病变明显减少,支架内局限性再狭窄和支架近端局限性再狭窄明显增多(P<0.05或0.01)。结论:金属裸支架置入处再狭窄发生率高,影像形态学以支架内弥漫和支架内弥漫累及两端为主;药物涂层支架再狭窄率低,影像形态学以支架内局限和支架近端局限多见。

OBJECTIVE： To compare morphological differences of intracranial target vessel restenosis following various stent implantations. METHODS： 182 patients with intracranial arteriostenosis were selected from the Fourth Hospitals of China Medical University between May 2003 and May 2007, and divided into bare stent group （n=74, 98 stents） and drug stent group （n=108, 137 stents）. All patients were followed up for 15 months, and underwent digital subtraction angiography to evaluate morphological changes of target vessel restenosis. RESULTS： Compared with bare stent group, the restenosis rates were significantly reduced in drug-eluting stent group （P 〈 0.05） the incidence of suffusion proliferation diseases reduced but intra-stent limitation and proximal stent limitation significantly increased （P 〈 0.05 or 0.01）. CONCLUSION： Incidence of restenosis is high following bare-mental stent implantation, and morphological images mainly exhibit intra-stent suffusion and intra-stent involved suffusion. While, incidence of restenosis is low following drug stent implantation, and morphological images mainly exhibit intra-stent limitation and proximal stent limitation.