Incidence, risk, and treatment of binary restenosis after vertebral artery stenting
Incidence, risk, and treatment of binary restenosis after vertebral artery stenting
复制标题
椎动脉支架置入术后二元再狭窄的发生率、风险和治疗
DOI：
10.1002/ccd.28906
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发表时间：
2020-04-11
影响因子：
2.3
通讯作者：
Jiang, Yongjun
中科院分区：
文献类型：
--
作者：
Qiu, Zhihua;Liu, Jun;Jiang, Yongjun
支架内再狭窄（ISR）是椎动脉支架置入术（VAS）的主要问题。目的探讨椎动脉再狭窄（ISR）再次血管成形术的可行性及疗效。对有症状的ISR（>50%）或无症状的ISR（>= 70%）进行重做血管成形术，包括球囊血管成形术和支架植入术。在第1、3、6和12个月进行临床随访，然后每年在诊所或通过电话进行随访。结果72例患者出现明显的缺血再狭窄，48例（92.3%，48/52）再次血管成形术成功，其中13例位于V4，35例位于椎动脉口。26处病变植入第二枚支架，其余病变接受球囊血管成形术。围手术期无脑卒中和短暂性脑缺血发作（TIA）发生。1例患者在再次血管成形术后2个月因非卒中原因死亡。与药物治疗相比，再次血管成形术未显著降低卒中或TIA。16例患者出现二次再狭窄，支架植入术组的二次再狭窄率低于球囊血管成形术组。结论二次血管成形术是一种可行的治疗VAS的ISR的方法，二次支架植入术可作为首选。
Background In-stent restenosis (ISR) is the major concern of vertebral artery stenting (VAS). We aimed to investigate the feasibility and outcome of redo angioplasty for ISR of vertebral artery.Method The patients were retrospectively reviewed for the significant ISR (>50%). Redo angioplasty including balloon angioplasty and stenting was performed for symptomatic ISR (>50%) or asymptomatic ISR (>= 70%). The clinical follow-up was performed on the 1, 3, 6, and 12 months and then yearly in the clinic or by telephone. The angiographic follow-up was performed at 6-12 months after redo angioplasty.Result A total of 72 patients had significant ISR and 48 redo angioplasty (92.3%, 48/52) were successfully achieved with 13 located in the V4 and 35 in the ostium of vertebral artery. Twenty-six lesions were implanted by the second stent and the others received balloon angioplasty. No stroke or transient ischemic attack (TIA) occurred in the perioperative time. One patient died 2 months after redo angioplasty due to nonstroke cause. Redo angioplasty nonsignificantly decreased the stroke or TIA compared with medical treatment. Sixteen patients developed the binary restenosis, which was lower in the patients receiving stent implantation than balloon angioplasty.Conclusion Redo angioplasty was a feasible method for the ISR of VAS and redo stenting might be the first choice.