Neuroform EZ在重度症状性颅内动脉粥样硬化性狭窄血管内治疗中的疗效评价

Evaluation of Neuroform EZ stenting in endovascular treatment of severe symptomatic intracranial atherosclerotic stenosis

目的评估Neuroform EZ支架植入治疗重度症状性颅内动脉粥样硬化性狭窄(sICAS)的安全性和有效性。方法回顾性分析2017年6月至2020年6月于我中心采用Neuroform EZ支架治疗的23例sICAS患者临床及影像学资料。记录并分析病变特点、支架植入技术成功率、术后狭窄程度变化、围手术期及随访期间卒中事件或死亡事件发生以及支架内再狭窄情况。结果23例患者植入Neuroform EZ支架23枚,技术成功率100%;术后狭窄率由术前的(85.52±8.89)%降为(19.97±10.90)%,差异具有统计学意义(P<0.05);围手术期出现缺血并发症1例(4.35%),表现为穿支卒中,无出血并发症及死亡患者。获得数字减影血管造影(DSA)随访17例(73.91%),随访期3~24个月(平均7.00个月),随访期间出现再狭窄2例(11.76%),均为无症状狭窄。23例均获得临床随访(100%),随访期1~33个月(平均10.48个月),末次随访时患者mRS评分由术前的1(1,2)分降至1(0,1)分,差异具有统计学意义(P<0.05)。随访期间2例(8.70%)患者出现新发小面积脑梗死,其中1例为无症状性脑梗死,均非原术区血管责任病灶。结论Neuroform EZ支架治疗重度sICAS的技术成功率高,操作难度较低,治疗相对安全,短期疗效较好;但尚需加大样本量、延长随访时间以进一步验证上述结论。

Objective To evaluate the safety and efficacy of Neuroform EZ stent implantation in the treatment of severe symptomatic intracranial atherosclerotic stenosis(sICAS).Methods From June 2017 to June 2020,the clinical and imaging data of 23 patients with SICAS underwent Neuroform EZ stent implantation were analyzed retrospectively.The characteristics of lesions,the success rate of stent implantation,the change of postoperative stenosis degree,the occurrence of stroke or death events during perioperative period and follow-up period,and the in-stent restenosis were recorded and analyzed.Results 23 Neuroform EZ stents were implanted in 23 patients with a technical success rate of 100%.The postoperative stenosis rate decreased from 85.52±8.89%to 19.97±10.90%(P<0.05).Ischemic complications occurred in 1 case(4.35%)during perioperative period,showing perforator stroke.No bleeding complications or death occurred.17 cases(73.91%)were followed up by DSA for 3-24 months(average 7.00 months),and 2 cases(11.76%)had restenosis during the follow-up period,all of which were asymptomatic stenosis.All 23 patients were followed up clinically(100%)for 1-31 months(average 10.48 months).At the last follow-up,the average mRS score decreased from 1(1,2)before operation to 1(0,1)with significantly difference(P<0.05).During the follow-up period,2 patients(8.70%)had new small-area cerebral infarction,one of which was an asymptomatic cerebral infarction,none of which was the vascular lesion in the original operation area.Conclusions Neuroform EZ stent has high technical success rate,low operation difficulty,relatively treatment safety and good short-term effect in the treatment of severe sICAS.However,it is necessary to increase the sample size and prolong the follow-up time to further verify the above conclusions.