肝素化支架在头颈部动脉狭窄治疗中的应用

Application of heparin-coated stent in treatment of neck and cranial atherosclerotic stenosis

目的 :探讨肝素化血管内支架在头颈部动脉狭窄治疗中的安全性和有效性。 方法 :39例反复短暂性脑缺血发作(TIA)、动脉狭窄程度在 5 0 %以上且药物治疗无效的头颈部动脉狭窄患者 ,均采用直接肝素化 BX冠状动脉支架植入治疗 ,术后未予肝素化治疗。结果 :本组 39例患者均成功地植入支架 ,无手术相关并发症。 2 5例患者狭窄血管恢复正常直径 ,10例狭窄程度减少 90 %以上 ,4例残余狭窄 10 %～ 2 5 %。临床随访 3～ 18个月 ,33例症状完全缓解 ,5例明显好转 ,1例症状无改善。19例 DSA随访 6～ 12个月 ,无 1例发生支架内血栓或再狭窄。结论 :肝素化支架在头颈部动脉狭窄的治疗中是安全的 ,可有效降低血栓和再狭窄的发生。

Objective: To determine the safety and efficacy of heparin coated stent in treatment of atherosclerotic intracranial stenosis.Methods: Thirty nine patients with symptomatic intracranial stenosis (more than 50%) refractory to medical therapy were treated with primary heparin coated stents (BX velocity,Johnson) implantation,and none of them received heparin after the procedures.Results: Technical success was achieved in all patients with no complications related to the procedure.Angiographic results immediately after stenting suggested that the total disappearance of stenosis was obtained in 25 patients,the degree of stenosis reduced more than 90% in 10 patients,and 10% 25% residual stenosis remained in 4 patients.At follow up for 3 18 months,clinical symptoms disappeared in 33 patients,improved in 5 cases,remained stable in one case.Follow up of 19 patients revealed no restenosis or thrombosis in stent.Conclusion: Heparin coated stents are safe in treatment of neck and cranial stenosis,and may prevent thrombosis and restenosis.