Wingspan支架治疗症状性大脑中动脉狭窄的并发症分析

Complications of stenting with Gateway-Wingspan system for symptomatic middle, cerebral artery stenosis

目的分析Gateway—Wingspan支架系统治疗症状性大脑中动脉狭窄的并发症，探讨其安全性。方法回顾性分析应用Wingspan支架治疗47例症状性大脑中动脉狭窄患者的临床资料，研究并发症发生的原因。结果4例出现了围手术期并发症，并发症发生率为8．5％（4／47）。其中术中血管痉挛1例；过度灌注出血1例，抢救无效死亡；穿支破裂出血1例；亚急性血栓形成1例。症状性颅内出血2例（4．3％，2／47），死亡1例（2．1％，1／47），严重并发症3例（6．4％，3／47）。支架均成功置入，技术成功率100％，患者术前平均狭窄率为（83．5±10．0）％，Wingspan支架置入后平均残余狭窄率为（19．8±9．2）％。结论Wingspan支架治疗症状性大脑中动脉狭窄技术成功率高，本组的围手术期并发症及症状性颅内出血相对较高，需要进一步临床实践检验。

Objective To investigate the safety of treatment of symptomatic middle cerebral artery stenosis with Gateway-Wingspan system by reviewing the data on complications. Methods Forty-seven patients with symptomatic middle cerebral artery stenosis treated with Wingspan system were respectively analyzed and emphasis was paid to cases with complications. Relevant data was collected such as characteristics of patients and lesions,selection of ballon and stent and radiographic information. Results Complications were found in 4 patients （8.5%）, which were due to cerebral vasospasm, heperperfution syndrome, artery branch rupture and subaeute stent thrombosis respectively. Two patients experienced symptomatic intraeranial hemorrhage （4. 3% ） and one of them died （2. 1% ）. The morbidity of severe complications was 6.4%. The success rate of stent implantation was 100%. Mean artery stenosis reduced from （ 83.5±10. 0） % to （ 19. 8±9.2 ） % after Wingspan stent implantation. Conclusion Middle cerebral artery stenting angioplsty greatly improved the stenosis with high technical success rate. However, the rates of cerebral vascular complications and symptomatic intracranial hemorrhage were relatively high in this study ,which needs to be widely verified in practice.