Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2025, Vol. 25 ›› Issue (5): 411-415. doi: 10.3969/j.issn.1672-6731.2025.05.008

• Clinical Study of Cerebrovascular Disease • Previous Articles     Next Articles

Efficacy and safety of balloon dilation versus stent implantation in young ischemic stroke patients with symptomatic intracranial artery stenosis

He ZHANG, Lin-jie YU, Xi ZHANG, Yun LUO, Yun XU, Jing-wei LI*()   

  1. Department of Neurology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China
  • Received:2025-03-31 Online:2025-05-25 Published:2025-06-05
  • Contact: Jing-wei LI
  • Supported by:
    General Program of Health Commission of Jiangsu Province(M2021064)

青年症状性颅内动脉狭窄性缺血性卒中球囊扩张术与支架植入术疗效对比分析

张贺, 于林杰, 张曦, 罗云, 徐运, 李敬伟*()   

  1. 210008 南京大学医学院附属鼓楼医院神经内科
  • 通讯作者: 李敬伟
  • 基金资助:
    江苏省卫健委面上科研项目(M2021064)

Abstract:

Objective: To compare the efficiency and safety between balloon dilation and stent implantation in young ischemic stroke patients with symptomatic intracranial artery stenosis (ICAS). Methods: Total 37 young ischemic stroke patients who received endovascular treatment in Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School from February 2019 to February 2023 were enrolled. According to the Mori classification and the location of the lesions, balloon dilation was performed in 12 cases and stent implantation was performed in 25 cases. The primary outcomes were vascular restenosis rate, stroke recurrence rate and mortality events during the follow? up period (3-12 months after operation), and the secondary outcomes were the surgical success rate and the peri?operative complications rate. Results: For the primary outcomes, after an average follow?up of (5.21 ± 2.19) months, among the 36 patients who completed the follow? up, 6 cases (16.67%) had vascular restenosis, with 2 cases (2/12) in balloon dilation group and 4 cases (16.67%) in stent implantation group. There was no statistically significant difference between the 2 groups (Fisher's exact probability: P = 1.000). No stroke recurrence or mortality events occurred. For the secondary outcomes, the surgical success rate reached 100% (37/37). Three cases (8.11%) experienced peri?operative complications, with one case (1/12) in balloon dilation group and 2 cases (8%) in stent implantation group. There was no statistically significant difference between the 2 groups (Fisher's exact probability: P = 1.000). No thrombosis occurred within the stent or the diseased blood vessels. Conclusions: For young ischemic stroke patients with ICAS, the efficacy and safety of balloon dilation and stent implantation are comparable. Further exploration through multicenter, large?sample clinical trials are needed.

Key words: Ischemic stroke, Intracranial arteriosclerosis, Young adult, Angioplasty, balloon, Stents

摘要:

目的: 对比分析球囊扩张术与支架植入术治疗青年症状性颅内动脉狭窄性缺血性卒中的有效性和安全性。方法: 纳入2019年2月至2023年2月在南京大学医学院附属鼓楼医院接受血管内治疗的37例青年症状性颅内动脉狭窄性缺血性卒中患者,根据Mori分型和病变部位分别予单纯球囊扩张术(球囊扩张组,12例)和球囊预扩张+ 支架植入术(支架植入组,25例),主要结局为随访期间(术后3 ~12个月)血管再狭窄率、脑卒中复发率和致死性事件发生率,次要结局为手术成功率和围手术期并发症发生率。结果: 主要结局,术后平均随访(5.21 ± 2.19)个月,36例完成随访患者中6例(16.67%)出现血管再狭窄,球囊扩张组2例(2/12)、支架植入组4例(16.67%),组间差异无统计学意义(Fisher确切概率法:P = 1.000);均未发生脑卒中复发或致死性事件。次要结局,手术成功率达100%(37/37);3例(8.11%)出现围手术期并发症,球囊扩张组1例(1/12)、支架植入组2例(8%),组间差异亦无统计学意义(Fisher确切概率法:P = 1.000);均未发生支架内或病变血管内血栓形成。结论: 对于青年症状性颅内动脉狭窄性缺血性卒中患者,球囊扩张术与支架植入术的疗效和安全性相当,尚待多中心、大样本临床试验进一步探索。

关键词: 缺血性卒中, 颅内动脉硬化, 青年人, 血管成形术,气囊, 支架