症状性颅内动脉狭窄行支架治疗的疗效分析

Analysis of symptomatic intracranial artery stenosis treated by intracranial stenting

目的探讨对症状性颅内动脉粥样硬化性狭窄低灌注患者治疗中,颅内支架置入能否使患者获得较好的临床获益与风险比。方法回顾性分析41例缺血性卒中患者(经脑血管造影显示IAS)的资料,分为支架组(行颅内支架置入术)、药物组,观察患者围手术期、随访期间主要终点事件。结果手术成功率100%,围手术期大的并发症1例。平均随访11.2个月,12个月时对比NIHSS评分好转情况,支架组1例术后并发脑梗死后遗留后遗症,并发症发生率4.5%,12个月随访时NIHSS评分较术前增加3分,余21例平均NIHSS评分下降5.4分。药物治疗组患者12个月随访,脑卒中复发率10.5%,1例出院后4个月发生再次卒中,12个月时NIHSS评分增加4分,1例出院8个月后再次卒中,12个月时NIHSS评分增加5分,余17例12个月随访时平均NIHSS评分下降3.8分。结论对灌注低的症状性IAS患者,行颅内支架置入,患者可能获益更多。

Objective To explore intracranial stenting can get better clinical results for low perfusion in patients with symptomatic intracranial artery stenosis. Methods Methods A retrospective analysis was made on 41 ischemic stroke patients treated in our hospital from February 2010 to November 2013 (after cerebral angiography showed IAS). Patients were divided into stent group (intracranial stenting) and the drug group ,the primary endpoint was observed perioperation and follow‐up pe‐riod.Results The success rate of surgery was 100% ,1 case with perioperative complication. The mean follow‐up was 11.2 months ,the NIHSS score improved at follow up to 12 months ,1 patient in stent group complicated with cerebral infarction , the rate was 4.5% ,until 12‐month follow‐up ,NIHSS score increased by 3 points ,the average NIHSS score of 21 patients de‐creased 5.4 points. Drug group was followed up 12 months ,stroke recurrence rate was 10.5% ;1 case recurred 4 months after discharge ,NIHSS score increased 4 points at the 12th month ;1 patient occur again 8 months after discharge ,NIHSS score in‐creased 5 points at the 12th month ;the average NIHSS score of other 17 patients decreased 3.8 points at the 12th month. Pa‐tients with intracranial stent implantation with low perfusion features had more clinical benefit.Conclusion Conclusion For low perfusion in patients with symptomatic IAS ,intracranial stenting may get benefit more.