颈动脉支架置入术后支架内再狭窄研究进展

Research progress of restenosis after carotid stenting

颈动脉狭窄作为缺血性卒中的一个重要致病因素,备受科研人员和临床医师的重视。目前,颈动脉狭窄的外科治疗首选颈动脉内膜切除术(CEA)。颈动脉支架置入术(CAS)也是颈动脉狭窄的治疗方案之一,尤其对于CEA高风险患者,CAS为最佳治疗手段。CAS具有侵入性较小、患者不适感更低以及住院时间短的优势,但部分患者可能出现CAS后支架内再狭窄(ISR),ISR与短暂性脑缺血发作及缺血性卒中复发等临床事件密切相关。作者就CAS术后ISR形成的机制、影响因素及其预防与治疗的研究进展进行综述,以期为临床医师的诊疗提供一定的参考。

As an important pathogenic factor of ischemic stroke,carotid artery stenosis has attracted the attention of researchers and clinicians.At present,carotid endarterectomy(CEA)is the first-line choice for the surgical treatment of carotid artery stenosis.Carotid artery stenting(CAS)is also one of the treatment options for carotid artery stenosis,and the best treatment especially for patients with high risk of CEA.CAS has the advantages of less invasiveness,lower patient discomfort,and shorter hospitalization.However,some patients may experience in-stent restenosis(ISR),which is closely related to clinical events such as transient ischemic attack and recurrence of ischemic stroke.The authors reviewed the research progress of formation mechanism,predictive factors,prevention and treatment of ISR after CAS,in order to provide reference of ISR diagnosis and treatment to clinicians.