椎动脉近端支架植入术后支架内再狭窄危险因素分析

doi:10.3969/j.issn.1672-6731.2020.06.010

中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (6): 528-533. doi: 10.3969/j.issn.1672-6731.2020.06.010

2 椎动脉近端支架植入术后支架内再狭窄危险因素分析

陆军, 吴卓毅, 王俊杰, 祁鹏, 王大明

100730 北京医院神经外科国家老年医学中心

收稿日期:2020-06-17 出版日期:2020-06-25 发布日期:2020-06-24
通讯作者: 王大明,Email:daming2000@263.net
基金资助:
中国医学科学院中央级公益性科研院所基本科研业务费专项基金资助项目（项目编号：2019TX320002）

Analysis of risk factors for in-stent restenosis after proximal vertebral artery stent implantation

LU Jun, WU Zhuo-yi, WANG Jun-jie, QI Peng, WANG Da-ming

Department of Neurosurgery, Beijing Hospital;National Center of Gerontology, Beijing 100730, China

Received:2020-06-17 Online:2020-06-25 Published:2020-06-24
Supported by:
This study was supported by Non - Profit Central Research Institute Fund of Chinese Academy of Medical Sciences (No. 2019TX320002).

摘要/Abstract

摘要：

目的探讨椎动脉近端支架植入术后支架内再狭窄的危险因素。方法以2007年1月至2017年6月行椎动脉近端支架植入术且术后经CTA或DSA随访的155例椎动脉近端狭窄致后循环缺血患者为观察对象，通过DSA观察椎动脉近端支架植入侧别、支架直径和长度、支架类型（裸金属支架或药物洗脱支架）、椎动脉近端狭窄改善情况，单因素和多因素前进法Logistic回归分析探讨术后支架内再狭窄相关危险因素。结果 155例患者共植入178枚球囊扩张式支架，支架内再狭窄率为30.90%（55/178）。Logistic回归分析显示，合并基底动脉狭窄（OR=4.468，95% CI：1.685~11.849；P=0.003）和支架直径2.5~3.5 mm（OR=5.126，95% CI：1.748~15.033；P=0.003）是椎动脉近端支架植入术后支架内再狭窄的危险因素。结论合并基底动脉狭窄和植入支架直径偏小是椎动脉近端支架植入术后支架内再狭窄的危险因素。

关键词: 椎底动脉供血不足, 血管成形术, 支架, 危险因素, Logistic模型

Abstract:

Objective To investigate risk factors for in-stent restenosis after proximal vertebral artery (VA) stenting. Methods One hundred and fifty-five patients underwent balloon-expandable stent assisted-angioplasty for symptomatic proximal VA stenosis from Januray 2007 to June 2017, and CTA or DSA were examined. The risk factors for in-sent restenosis after proximal VA stenting were investigated via univariate and multivariate forward Logistic regression analysis. Results One hundred and fifty-five patients were treated with 178 balloon-expandable stents. The in-sent restenosis rate was 30.90% (55/178). Univariate and multivariate forward Logistic regression analysis found that coexist of basilar artery stenosis (OR=4.468, 95% CI:1.685-11.849; P=0.003) and stent diameter 2.5-3.5 mm (OR=5.126, 95% CI:1.748-15.033; P=0.003) were risk factors for in-sent restenosis. Conclusions Coexist of basilar artery stenosis and smaller stent diameter were risk factors for in-stent restenosis after proximal VA stentintg.

Key words: Vertebrobasilar insufficiency, Angioplasty, Stents, Risk factors, Logistic models

陆军, 吴卓毅, 王俊杰, 祁鹏, 王大明. 椎动脉近端支架植入术后支架内再狭窄危险因素分析[J]. 中国现代神经疾病杂志, 2020, 20(6): 528-533.

LU Jun, WU Zhuo-yi, WANG Jun-jie, QI Peng, WANG Da-ming. Analysis of risk factors for in-stent restenosis after proximal vertebral artery stent implantation[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(6): 528-533.

http://journal11.magtechjournal.com/cjcnn/CN/Y2020/V20/I6/528

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2 椎动脉近端支架植入术后支架内再狭窄危险因素分析

Analysis of risk factors for in-stent restenosis after proximal vertebral artery stent implantation

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