颈动脉支架植入后支架表面新生内膜增生与斑块内新生血管的关系探讨

Relationship between in-stent neointimal hyperplasia and intra-plaque neovascularization after carotid artery stenting

目的探讨颈动脉支架植入术(carotid artery stenting,CAS)后支架表面新生内膜增生与斑块内新生血管的关系。方法纳入西安交通大学第一附属医院2014~2016年接受CAS治疗的67例患者,使用超声造影评估术后1年内颈动脉斑块内新生血管及支架表面新生内膜增生情况。结果10例患者在支架植入后1年内出现支架表面新生内膜增生。CAS术后第6、12个月,新生内膜组斑块内新生血管G2级所占百分比显著高于非新生内膜组(P分别=0.002和<0.001)。CAS后支架内新生内膜增生与斑块内新生血管呈显著的正相关关系(r=0.425,P<0.001)。结论颈动脉支架植入后支架表面新生内膜增生与斑块内新生血管丰富程度有关,监测斑块内新生血管可能预测新生内膜增生。

Objective To investigate the relationship between in-stent neointimal hyperplasia(NH)and intra-plaque neovascularization(IPN)after carotid artery stenting(CAS).Methods Sixty-seven patients who were treated with CAS from the First Affiliated Hospital of Xi'an Jiaotong University from 2014 to 2016 were included.Contrast-enhanced ultrasound(CEUS)was used to evaluate the IPN in the carotid artery and the NH on the stent surface within one year after CAS.Results Ten patients had NH on the stent surface within 1 year after CAS.At the 6 th and 12 th months after the operation,the percentage of IPN at G2 level in the NH group was significantly higher than that in the non-NH group(P=0.002 and<0.001,respectively).There was a significant positive correlation between NH in the stent and IPN after CAS(r=0.425,P<0.001).Conclusion The NH in-stent after CAS is related to the richness of the IPN.Monitoring IPN may predict NH.