颈动脉支架内再狭窄危险因素分析

Risk Factors of In-stent Restenosis after Carotid Artery Stent

目的评估颈动脉支架术后支架内再狭窄的发生率并分析一些再狭窄可能的危险因素,为临床治疗和预防术后支架内再狭窄(ISRs)提供依据。方法回顾性选择了50例在笔者医院行CAS的患者,收集并分析与支架内狭窄可能相关的临床,影像和手术操作等资料,平均随访2.8年。结果 50例患者中男性占72%(36/50);平均年龄63.1±8.3岁,52处狭窄病变放置60枚支架,术后发生ISRS 7例(13.46%),其中置入两枚支架者ISRS 50%(4/8),置入一枚支架者ISRS 6.82%(3/44)(P<0.05);术后有残余狭窄ISRS 45.45%(5/11),无残余狭窄ISRS 4.88%(2/41)(P<0.05)。多因素回归分析显示,支架内再狭窄与置入支架数量及术后残留狭窄相关(P<0.05)。结论支架置入数量和支架术后残余狭窄可能是ISRS的独立危险因素,根据狭窄病变选择适宜的支架以及尽量减少支架后残余狭窄对防止术后再狭窄至关重要。

Objective To assess the incidence of in - stent restenosis （ISRS） after CAS and to identify some predictors of restenosis and develop effective way to improve clinical treatment and precaution of restenosis. Methods We retrospectively selected 50 treated pa- tients and we obtained and analysis clinical, radiological, and procedural variables to stent restenosis. Mean time of follow - up was 2.8 months. Results CAS was performed in 50 patients,and 72% （36/50） were male. Mean age was 63.1 ± 8.3 years. Seven （ 13.46% ） caces of ISRS （ 〉 50% ） were found by color duplex ultrasound scanning. The ISRS was 50% （4/8） in two pieces of implant stents, 6.82% （3/44） in one stent （P 〈0.05）. There were 45.45% （5/11） with residual narrow,and 4.88% （2/41） with no residual narrow （P 〈 O. 05）. The correlation analysis demonstrated that in - stent restenosis was correlated to stent quantity and residual stenosis （ P 〈 0. 05）. Conclusion The multiple stents deployment and percentage residual stenosis after CAS may be independent predictors of resteno- sis. In our CAS experience, adequate recanalization of the treated vessel and reducing the numbers of implanted stent are important to lim- it the development of stent restenosis.