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Stenting for symptomatic intracranial vertebrobasilar artery stenosis: 30-day results in a high-volume stroke center

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机构: [1]Capital Med Univ, China Natl Clin Res Ctr Neurol Dis, Dept Intervent Neuroradiol,Ctr Stroke, Beijing Tiantan Hosp,Beijing Inst Brain Disorders, Beijing 100050, Peoples R China; [2]3rd Peoples Hosp Liaocheng, Catheterizat Room Intervent Therapy, Liaocheng, Shandong, Peoples R China; [3]Capital Med Univ, China Natl Clin Res Ctr Neurol Dis, Beijing Tiantan Hosp, Dept Intervent Neuroradiol, 6 Tiantan Xili, Beijing 100050, Peoples R China
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关键词: Atherosclerosis Vertebrobasilar stenosis Angioplasty and stent

摘要:
Objectives: Symptomatic intracranial vertebrobasilar artery stenosis (IVBS) carries a high annual risk of recurrent stroke. Endovascular therapy was a promising technique but recent trials suggest it may carry a risk of periprocedual complications especially in inexperienced hands. This prospective study was to evaluate the safety of endovascular therapy for severe symptomatic IVBS in a high volume stroke centre. Patients and Method: Patients with symptomatic IVBS caused by 70-99% stenosis despite medical treatment of at least one antiplatelet agent and statin were enrolled. The patients were treated either with balloon-mounted stent or balloon pre-dilation plus self-expanding stent as determined by the operators following a guideline. The primary outcome was 30-day stroke, transient ischemic attack (TIA) and death after stenting. The secondary outcome was successful stent deployment. The baseline characteristics and outcomes of patients with basilar artery (BA) lesions and patients with vertebral artery V4 segment lesions (BA group vs V4 group) were compared. And the outcome of different Mori type lesions was also compared. Result: From September 2013 to September 2014, 105 patients with stroke or TIA due to intracranial IVBS were screened and 97 patients were treated by stenting, including 52 patients with BA stenosis and 45 patients with V4 stenosis. The rate of 30-day stroke, TIA and death was 7.1%. All the three strokes happened in the BA group and were perforator strokes. The successful stent deployment rate was 100%. General anesthesia was more preferred in the BA group than in the V4 groups (96.2% vs 75.6%, p = 0.005). The Apollo stent was used more for Mori A lesions (30.5% vs 7.9%, p = 0.011) and had lower degree of residual stenosis (8.6% vs 12.6%, p = 0.014) than Wingspan stent. Mori C lesions were more likely to have higher degree of residual stenosis than Mori A lesion (15.3% vs 7.4%, p = 0.005). Conclusion: The short-term safety of endovascular stenting for patients with severe symptomatic IVBS in a high volume stroke centre was acceptable. Mori A lesions may have lower residual stenosis rate than the Mori C type lesions. (C) 2016 Published by Elsevier B.V.

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出版当年[2015]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 外科
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出版当年[2014]版:
Q3 SURGERY Q4 CLINICAL NEUROLOGY
最新[2023]版:
Q2 SURGERY Q3 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

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第一作者机构: [1]Capital Med Univ, China Natl Clin Res Ctr Neurol Dis, Dept Intervent Neuroradiol,Ctr Stroke, Beijing Tiantan Hosp,Beijing Inst Brain Disorders, Beijing 100050, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, China Natl Clin Res Ctr Neurol Dis, Dept Intervent Neuroradiol,Ctr Stroke, Beijing Tiantan Hosp,Beijing Inst Brain Disorders, Beijing 100050, Peoples R China; [3]Capital Med Univ, China Natl Clin Res Ctr Neurol Dis, Beijing Tiantan Hosp, Dept Intervent Neuroradiol, 6 Tiantan Xili, Beijing 100050, Peoples R China
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