Spontaneous improvement of peristent ulceration after carotid artery stenting
Spontaneous improvement of peristent ulceration after carotid artery stenting
复制标题
颈动脉支架置入术后持续性溃疡的自发改善
DOI：
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发表时间：
2006
期刊：
影响因子：
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通讯作者：
A. Tanaka
中科院分区：
文献类型：
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作者：
S. Kohyama;K. Kazekawa;M. Iko;H. Aikawa;M. Tsutsumi;Y. Go;S. Nagata;T. Kodama;K. Nii;S. Matsubara;A. Tanaka
背景和目的：由于颈动脉斑块溃疡与脑栓塞风险增加相关，颈动脉血管成形术和支架置入术（CAS）后直接在支架周围残留颈动脉斑块溃疡（持续性溃疡）仍可能是卒中的风险因素。本研究的目的是了解持续性溃疡的形态学和临床预后。患者和技术：对91处连续狭窄病变（80例患者）尝试了CAS。其中，54处病变（48例患者）在CAS前有溃疡。术后立即评价血管造影片。30例（34个病灶）出现持续性溃疡。持续性溃疡的平均深度和长度分别为2.1 mm（范围，1-4.7 mm）和8.9 mm（范围，1.5-22 mm）。所有持续性溃疡患者均接受抗血小板治疗。结果：在平均25.5个月（范围，3-48个月）的随访期内，没有发生因病变引起的缺血事件。CAS后平均5.8个月（范围，1-21个月）对25处病变（21例患者）进行的血管造影显示，12处病变（48%）的持续性溃疡消失，11处病变（44%）改善，2处病变（8%）保持不变。9处病变（36%）显示再狭窄，≤30%，不需要任何额外干预。在CAS后平均9个月（范围，1-32个月）接受随访MR成像的14例患者（17处病变）中，未检测到新的缺血性病变。结论：我们得出结论，CAS后持续性溃疡自发改善，不是脑栓塞的危险因素。
BACKGROUND AND PURPOSE: Because carotid plaque ulceration is associated with an increased risk of cerebral embolism, residual carotid plaque ulceration directly around a stent (peristent ulceration) after carotid angioplasty and stent placement (CAS) could still be a risk factor for a stroke. The purpose of this study is to understand the morphologic and clinical prognosis of peristent ulceration. PATIENTS AND TECHNIQUES: CAS was attempted on 91 consecutive stenotic lesions (80 patients). Of these, 54 lesions (48 patients) had ulceration before CAS. Angiograms were evaluated immediately after the procedure. Peristent ulceration was found in 34 lesions (30 patients). The mean depth and length of peristent ulcers were 2.1 mm (range, 1–4.7 mm) and 8.9 mm (range, 1.5–22 mm), respectively. All patients with peristent ulceration were followed with antiplatelet therapy. RESULTS: No ischemic event due to the lesions occurred during the mean follow-up period of 25.5 months (range, 3–48 months). Angiography on 25 lesions (21 patients) at a mean of 5.8 months (range, 1–21 months) after CAS showed that peristent ulceration disappeared in 12 lesions (48%), improved in 11 lesions (44%), and remained unchanged in 2 lesions (8%). Nine lesions (36%) showed restenosis, which were ≤30% and did not require any additional intervention. New ischemic lesions were not detected in any of the 14 patients (17 lesions) who underwent follow-up MR imaging at a mean of 9 months (range, 1–32 months) after CAS. CONCLUSION: We conclude that peristent ulceration after CAS improves spontaneously and is not a risk factor for cerebral embolism.
影响因子：
4.3
作者：
Troyer, A;Saloner, D;Rapp, JH
通讯作者：
Rapp, JH