颅内动脉狭窄支架置入与植入材料的生物相容性

Intracranial artery stenosis stent implantation and biocompatibility

背景:颅内动脉狭窄支架按照结构和材质可将血管内支架分为金属支架、聚合物支架、涂层支架等类型。那么哪一种支架更具临床应用价值呢?目的:对颅内动脉狭窄支架置入治疗的理论、应用、并发症及疗效进行评定,并分析植入材料的生物相容性。方法:应用计算机应用计算机检索PubMed数据库及西文生物医学期刊文献数据库(EMCC)2000-01/2010-10期间的相关文章,检索词为"Intracranial arterial stenosis,stent Implantation",并限定文章语言种类为English。同时计算机检索中国期刊全文数据库(CNKI)等2000-01/2010-10期间的相关文章,检索词为"颅内动脉狭窄,支架置入",并限定文章语言种类为中文。此外还手工查阅相关专著数部。纳入不同材料支架置入治疗颅内动脉狭窄的研究,包括基础研究、临床应用、并发症及材料的生物相容性评定。初检得到151篇文献,根据纳入标准选择33篇文章进行分析。结果与结论:颅内动脉狭窄的支架置入治疗较单纯药物治疗有明显的优势。近年来,随着冠脉支架及Wingspan支架的运用,支架治疗颅内动脉狭窄已成为一种安全有效的方法。虽然支架置入治疗后会发生不同并发症如再狭窄、脑出血高灌注综合征、缺血性脑卒中等,但支架治疗颅内动脉狭窄在短期及中期有很好的疗效,同时远期疗效还有待进一步研究。提示,支架置入治疗颅内动脉狭窄是一种安全的方法,短、中期内有效,但远期疗效有待进一步研究。药物涂层支架和Wingspan支架与人体的生物相容性并没有显著差异,尚待进一步论证。

BACKGROUND：According to structure and materials,the intracranial artery stenosis stent can be divided into metal,polymer,and coating stents.Which one is more suitable for clinical practice remains unclear.OBJECTIVE：To evaluate intracranial artery stenosis stents from the theory,applications,complications and efficacy,in addition,to analyze the biocompatibility of stent.METHODS：PubMed and English Medical Current Contents（EMCC） were searched using key words of ＂intracranial arteriostenosis,stent placement＂ for English papers.Meantime,CNKI was searched using key words of ＂intracranial stenosis,stent placement＂ and the language was limited in Chinese.In addition,relevant monographs were manual searched.Manuscripts addressing different materials of intracranial arterial stenosis stent were evaluated,including basic research,clinical applications,complications and efficacy evaluation.Totally 151 papers were searched,and 33 manuscripts were included.RESULTS AND CONCLUSION：Intracranial artery stenosis stent implantation has obvious advantages than simple drug treatment.In recent years,with the utilization of coronary stents and Wingspan stent,stent implantation has become a safe and effective method for treating intracranial artery stenosis.Although various complications,such as restenosis,cerebral hemorrhage hyperperfusion syndrome,ischemic stroke and so on,would occur after stent implantation,it still receive good short-and midterm outcomes in the treatment of intracranial arterial stenosis.The long-term effect remains to be studied further.The treatment of intracranial artery stenosis stent implantation receives good short-and med term effective,but long-term effect needs further study.There are no significant different of biocompatibility between drug coating stent and Wingspan stent to human body.