Enterprise支架治疗症状性颅内动脉粥样硬化性狭窄随访结果

The use of Enterprise stent in treating symptomatic intracranial atherosclerotic stenosis : follow-up observation results

目的评价Enterprise支架治疗症状性颅内动脉粥样硬化性狭窄(sICAS)的安全性和有效性。方法回顾性收集2012年1月至2017年12月在郑州大学第一附属医院接受Enterprise支架治疗的sICAS患者临床数据,分析患者基础参数、靶病变特点、技术成功率、围术期安全性和随访结果。结果共纳入sICAS患者27例(28处病变),植入Enterprise支架28枚。术前病变平均狭窄度为(75.7±6.7)%,术后平均残存狭窄度为(23.2±16.6)%,手术技术成功率100%。术后发生穿支事件并发症2例,未发生出血事件、动脉夹层、支架内血栓形成、高灌注综合征和心血管事件。所有患者平均随访(10.8±9.1)个月,发现3处支架内再狭窄(ISR)(≥50%,但无靶病变相关症状), ISR发生率为10.7%。未发生责任血管新发脑卒中、出血事件和死亡。结论球囊扩张后Enterprise支架植入治疗sICAS技术可行、安全有效,围术期并发症发生率低,随访结果良好,期待随机对照研究结果。

Objective To evaluate the safety and efficacy of the use of Enterprise stent in the treatment of symptomatic intracranial atherosclerotic stenosis(sICAS).Methods The clinical data of 27 patients with sICAS,who were treated with Enterprise stent implantation at First Affiliated Hospital of Zhengzhou University,China,during the period from January 2012 to December 2017,were retrospectively collected.The patient’s basic parameters,characteristics of target lesions,technical success rate,perioperative safety and follow-up results were analyzed.Results A total of 27 patients(28 lesions in total)were enrolled in this study,and a total of 28 Enterprise stents were implanted.The preoperative mean stenosis degree of lesions was(75.7±6.7)%,the postoperative residual stenosis degree was(23.2±16.6)%.The technical success rate was 100%.Postoperative complication of perforating branch events occurred in 2 patients.No severe complications such as hemorrhage,artery dissection,in-stent thrombosis,hyper-perfusion syndrome,or cardiovascular events occurred.All patients were followed up for(10.8±9.1)months,and 3 instent restenosis lesions(≥50%)were detected although the patients had no target lesion-related symptoms,the incidence of in-stent restenosis was 10.7%.No newly-developed stroke caused by responsible blood vessel,bleeding events or death occurred.Conclusion For the treatment of sICAS,balloon dilatation followed by Enterprise stent implantation is technically feasible,and clinically safe and effective.The incidence of perioperative complications is low and the follow-up results are satisfactory.Further randomized controlled trials are still needed before its long-term efficacy is clarified.