Zhongguo cuzhong zazhi (May 2022)
雷帕霉素洗脱支架与金属裸支架治疗症状性颅内动脉粥样硬化性狭窄的效果比较Comparison of Rapamycin-Eluting Stent with Bare-Metal Stent in Patients with Symptomatic IntracranialAtherosclerotic Stenosis
Abstract
Objective To observe the clinical efficacy and safety of rapamycin-eluting stent (RES) and baremetal stent (BMS) in treatment of symptomatic intracranial atherosclerotic stenosis (ICAS). Methods This retrospective study enrolled the patients with symptomatic ICAS who were treated with balloon expandable stents in the Affiliated Hospital of Qingdao University from July 2015 to December 2019. The patients were divided into RES group and BMS group. The baseline data, technical success (residual stenosis50%) rate were compared between the two groups. Results A total of 116 patients were enrolled in this study, with a mean age of 60.4±8.2 years and 75 males (64.7%), 46 cases in RES group and 70 cases in BMS group. There were no statistical differences in the baseline data, technical success rate and complications rate within 7 days between the two groups. The incidence of 1-year in-stent restenosis in RES group was lower than that in BMS group (0 vs . 20.0%, P =0.012). Conclusions RES has the same safety as the existing BMS in treatment of symptomatic ICAS, and it has a lower 1-year in-stent restenosis rate than BMS. 目的 观察研究雷帕霉素洗脱支架（rapamycin-eluting stent，RES）与金属裸支架（bare-metal stent， BMS）治疗症状性颅内动脉粥样硬化性狭窄（symptomatic intracranial atherosclerotic stenosis，ICAS）的临床疗效。方法 回顾性收集2015年7月-2019年12月青岛大学附属医院连续收治的行球囊扩张支架置入术治疗症状性ICAS患者的临床资料。根据术中所选支架类型分为RES治疗组和BMS治疗组，比较2组的基线资料、技术成功（血管残余狭窄＜30%）率、术后7 d内并发症（包括血管破裂、夹层、支架内血栓、卒中、TIA、脑出血、蛛网膜下腔出血等）发生率、1年支架内再狭窄（狭窄率＞50%）率的差异。结果 共纳入116例患者，平均年龄60.4±8.2岁，男性75例（64.7%），其中RES治疗组46例，BMS治疗组70例。2组的基线资料、技术成功率、术后7 d并发症发生率差异无统计学意义；RES治疗组的1年支架内再狭窄率为0，低于BMS治疗组的20.0%，差异具有统计学意义（P＝0.012）。结论 RES在治疗症状性ICAS患者方面具有与现有的BMS相同的安全性，且较BMS有更低的1年支架内再狭窄率。目前DES用于脑血管狭窄的研究较少，本研究通过对比RES和BMS治疗ICAS的有效性和安全性，发现RES术后1年支架内再狭窄率显著低于BMS，手术成功率和安全性与BMS相似，为RES在脑血管病介入治疗中的临床应用提供了一定依据。
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