CAJ | 학술논문

目的评价病变长度对颅内动脉支架成形术后再狭窄的影响.方法选取2004年3月至2009年9月成功实施球扩金属裸支架置入术治疗症状性颅内动脉粥样硬化性狭窄的住院患者65例,所有患者均行脑血管造影复查.按病变长度分为3组:短病变组(＜5 mm),中等长度病变组(5～10 mm)和长病变组(＞10 mm).支架内再狭窄定义为管腔狭窄＞50%或者管腔直径绝对值减少超过20%.分析不同病变长度对再狭窄的影响,并采用多元Cox回归逐步筛选出预测支架内再狭窄的独立风险因素.结果短病变组、中等长度病变组和长病变组各组病例数分别为28例、29例和8例.血管造影随访中位数时间为7个月(5～30个月),有19例发生再狭窄(29.2%).3组再狭窄率依次为:14.3%、37.9%和50%(P=0.045).Cox回归多因素分析显示病变长度[风险比(HR)=1.210,95%可信区间(CI)=1.011～1.446,P=0.037]和糖尿病(HR=2.630,95%CI=1.032～6.705,P=0.043)与再狭窄有关.结论病变长度和糖尿病是颅内动脉支架成形术后再狭窄的独立风险因素.
목적 평개병변장도대로내동맥지가성형술후재협착적영향.방법 선취2004년3월지2009년9월성공실시구확금속라지가치입술치료증상성로내동맥죽양경화성협착적주원환자65례,소유환자균행뇌혈관조영복사.안병변장도분위3조:단병변조(＜5 mm),중등장도병변조(5～10 mm)화장병변조(＞10 mm).지가내재협착정의위관강협착＞50%혹자관강직경절대치감소초과20%.분석불동병변장도대재협착적영향,병채용다원Cox회귀축보사선출예측지가내재협착적독립풍험인소.결과 단병변조、중등장도병변조화장병변조각조병례수분별위28례、29례화8례.혈관조영수방중위수시간위7개월(5～30개월),유19례발생재협착(29.2%).3조재협착솔의차위:14.3%、37.9%화50%(P=0.045).Cox회귀다인소분석현시병변장도[풍험비(HR)=1.210,95%가신구간(CI)=1.011～1.446,P=0.037]화당뇨병(HR=2.630,95%CI=1.032～6.705,P=0.043)여재협착유관.결론 병변장도화당뇨병시로내동맥지가성형술후재협착적독립풍험인소.
Objective To evaluate the effect of lesion length on in-stent restenosis (ISR) after intracranial stenting. Methods Between March 2004 and September 2009, 65 patients with symptomatic intracranial arterial stenosis were successfully implanted with single bare metal balloon-mounted stent. All received a conventional angiographic follow-up. The patients were divided into three groups according to lesion length: short lesions ( ＜5 mm), medium lesions (5-10 mm) and long lesions ( ＞10 mm). ISR was defined as ＞ 50% stenosis within stent or absolute luminal loss ＞ 20%. The influence of different lesion lengths on ISR was evaluated. Furthermore, the independent predictive factors for ISR were selected. Results There were short lesions ( n = 28 ), medium lesions ( n = 29 ) and long lesions ( n = 8 ). The median interval of angiographic follow-up was 7 months with a range of 5-30 months. Of 65 patients, 19 (29.2%) had ISR. The ISR rates were 14.3%, 37.9% and 50% in short lesions, medium lesions and long lesions respectively ( P = 0. 045 ). Multivariate Cox regression analysis showed that lesion length ( HR = 1.210; 95% CI= 1.011-1.446; P =0.037) and diabetes (HR=2.630; 95% CI= 1.032-6.705; P= 0. 043) were associated with ISR. Conclusion Lesion length and diabetes are two independent predictors for ISR after intracranial stenting.