Biodiv Ysio支架成形术在症状性大脑中动脉狭窄中的应用

Biodiv Ysio stent for symptomatic stenosis of middle cerebral artery

目的 研究BiodivYsio支架成形术治疗症状性大脑中动脉水平段 (M1段 )狭窄的安全性和可行性。方法 4 3例病人 4 5处症状性M 1段狭窄被纳入研究。狭窄位于M1主干 19处、开口部 12处、分叉部 14处。结果 技术成功率 97 8% (44 / 4 5 ) ;颅内出血并发症率 7 0 % (3/ 4 3例 ) ,其中1例死亡 (2 3% )。临床随访 (中位期 7个月 ) 4 1例 ,均未再发生缺血性神经事件。 6个月的造影随访6例 ,共 7支血管 ,6支显示了支架段良好开通 ,1支发生再狭窄。结论 在严格的方案下 ,采用BiodivYsio支架对症状性M 1段狭窄进行成形术是可行、安全和有效方法 ,但对于C型病变进行支架成形术和使用串联双支架需要慎重。有必要进一步加以研究。

Objective To assess the safety and feasibility of Biodiv Ysio stent for patients with symptomatic M1 stenosis of middle cerebral artery (MCA). Methods Forty-three patients with forty-five M1 stenoses,ranged from 50 % to 99 % in diameter reduction and refractory to medical therapy,were enrolled in this study between March 2002 and November 2003. The lesions were situated at M1 trunk ( n =19),M1 origin ( n =12) and M1 bifurcation ( n =14),respectively. Results The technical successful rate was 97.8 % (44 / 45) for all the lesions. The rate of complicating subarachnoid hemorrhage was 7.0% (3/43 patients) and the rate of death was 2.3 %. During a follow-up of 7.0 months (median),there was no recurrence of transient ischemic attack or stroke in 41 available patients. Six-month angiographic follow-up was obtained in 6 patients (7 vessels),demonstrating good patency in 6 stenting vessels and restenosis in one vessel. Conclusions Angioplasty associated with Biodiv Ysio stent appears to be a safe and feasible for the patients with symptomatic M1 stenosis of MCA,under strict control of periperformeral project. Further study is,however needed.