不同造影分型对大脑中动脉支架内再狭窄的影响

Effects of different angiographic types on in-stent restenosis of middle cerebral artery

  • 摘要:
      目的  比较不同造影分型对大脑中动脉支架内再狭窄(ISR)的影响。
      方法  选择行大脑中动脉支架置入术的患者116例作为研究对象,按照部位-形态学-路径分型(LMA分型)进行造影分型(部位分型分为7个亚型,形态学分型分为3个亚型,路径分型分为3个亚型),随访患者再狭窄发生情况,并分析大脑中动脉ISR的LMA分型影响因素。
      结果  116例患者共置入116枚支架,将随访复查显示再狭窄者18例纳入再狭窄组,无再狭窄者98例纳入无再狭窄组。2组部位分型比较,差异无统计学意义(P>0.05); 2组形态学分型、路径分型比较,差异均有统计学意义(P < 0.05); 单因素分析结果显示,颅内动脉LMA分型中的形态学分型和路径分型是动脉粥样硬化性大脑中动脉狭窄患者术后ISR的影响因素。
      结论  LMA分型中的形态学分型和路径分型是大脑中动脉ISR的影响因素,部位分型则不是ISR的影响因素。形态学分型为A型、B型者和路径分型为Ⅰ型、Ⅱ型者术后ISR发生率较低,预后较好,形态学C型和路径分型Ⅲ型患者宜考虑选用其他手术方法或保守治疗。

     

    Abstract:
      Objective  To compare effects of different angiographic types on in-stent restenosis (ISR) of middle cerebral artery.
      Methods  A total of 116 patients who underwent middle cerebral artery stenting were selected as study objects, and were divided into different types according to location-morphology-pathway (LMA classification), including seven subtypes according to location classification, three subtypes according to morphological classification, and three subtypes according to pathway classification. The restenosis conditions of patients were followed up and the influencing factors of LMA classification of middle cerebral artery ISR were analyzed.
      Results  A total of 116 stents were placed in 116 patients, among whom 18 restenosis cases in recheck results of follow-up were included in restenosis group, and 98 cases without restenosis were included in non-restenosis group. There was no significant difference between the two groups in location types (P>0.05). Significant differences were found in morphology type and pathway type (P < 0.05). The results of univariate analysis showed that the morphological and pathway classification of intracranial artery LMA classification were the influencing factors of postoperative ISR in patients with atherosclerotic middle cerebral artery stenosis.
      Conclusion  The morphological and pathway classification of intracranial artery LMA classification are the influencing factors of postoperative middle cerebral artery ISR, while location classification is not its influencing factor. The incidence rates of ISR with morphological type A and type B as well as pathway type Ⅰ and type Ⅱ are lower, and these patients have better prognosis. For patients with morphological type C and pathway classification Ⅲ, other surgery or conservative treatment may be considered.

     

/

返回文章
返回