In-Stent Stenosis of Stent Assisted Endovascular Treatment on Intracranial Complex Aneurysms
In-Stent Stenosis of Stent Assisted Endovascular Treatment on Intracranial Complex Aneurysms
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DOI：
10.3340/jkns.2010.48.6.485
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发表时间：
2010-12-01
影响因子：
1.6
通讯作者：
Kim, Young-Joon
中科院分区：
文献类型：
--
作者：
Yoon, Kyeong-Wook;Kim, Young-Joon
目的：方法：回顾性分析158例颅内复杂动脉瘤经血管内支架治疗后支架内狭窄的发生率及节段。其中，102例患者在6个月、12个月和18个月后接受了基于导管的血管造影术评价。结果：102例患者中，有8例（7.8%）患者在随访期间发现支架内狭窄。两名患者有未破裂的动脉瘤，六名患者有破裂的动脉瘤。Neuroform支架数量为7例（7.5%），Enterprise支架数量为1例（11.1%）。6例支架置入后6个月出现支架内狭窄，2例支架置入后12个月、18个月出现支架内狭窄。在我们的研究中，没有患者表现出症状性狭窄，除了继续抗血小板药物治疗外，没有患者需要进一步治疗。已知在复杂动脉瘤治疗期间，将支架置入非病理性载瘤动脉时，支架内狭窄很少，但作者发现在随访血管造影时容易发生。虽然在我们的病例中没有观察到相关症状，但在特定情况下，支架植入区域的管腔狭窄可能导致不良血流动力学事件。
Objective : To introduce the frequency and segment analysis of in-stent stenosis for intracranial stent assisted endovascular treatment on complex aneurysms.Methods : A retrospective study was performed in 158 patients who had intracranial complex aneurysms and were treated by endovascular stent application with or without coil embolization. Of these, 102 patients were evaluated with catheter based angiography after 6, 12, and 18 months. Aneurysm location, using stent, time to stenosis, stenosis rate and narrowing segment were analyzed.Results : Among follow-up cerebral angiography done in 102 patients, 8 patients (7.8%) were shown an in-stent stenosis. Two patients have unruptured aneurysm and six patients have ruptured one. Number of Neuroform stents were 7 cases (7.5%) and Enterprise stent in 1 case (11.1%). Six patients demonstrated in-stent stenosis at 6 months after stent application and remaining two patients were shown at 12 months, 18 months, respectively.Conclusion : In-stent stenosis can be confronted after intracranial stent deployment. In our study, no patient showed symptomatic stenosis and there were no patients who required to further treatment except continuing antiplatets medication. In-stent stenosis has been known to be very few when they are placed into the non-pathologic parent artery during the complex aneurysm treatment, but the authors found that it was apt to happen on follow up angiography. Although the related symptom was not seen in our cases, the luminal narrowing at the stented area may result the untoward hemodynamic event in the specific condition.