椎动脉起始部狭窄支架置入术后断裂合并再狭窄分析

摘要

目的:分析椎动脉起始部狭窄支架置入术后断裂的因素及处理.方法:对我院2010年11月-2012年6月椎动脉起始部狭窄支架置入术后断裂者进行回顾性分析,探讨可能影响支架断裂的因素及断裂后的处理.结果:在230例椎动脉起始部狭窄的患者的支架置入术后,经DSA检查证实发生支架断裂导致再狭窄的有10例患者,共计14枚支架发生断裂,其中有8例患者出现相关症状.支架本身的金属特性、椎动脉起始部狭窄处血管迂曲、支架内径偏小、支架覆盖正常段较长、释放压力过高与反复扩张等均与支架断裂相关.结论:选择合适支架,避免反复及过高压力的扩张及控制血压和戒烟可降低支架断裂率,减少支架置入术后再狭窄的发生.%Objective: To analyse the reasons of stent fracture in revascularization for symptomatic ostial vertebral artery stenosis. Methods: A retrospective study was performed to evaluate 230 patients with symptomatic ostial vertebral artery stenosis who underwent PTAS. Restenosis was found in 10 patients by DSA, with 14 stents fractured totall. As a result, 8 patients suffered con-elated symptoms. Results: Metallic characteristics, smaller internal diameter and longer length of stent, cir-cuity of ostial vertebral artery stenosis, as well as repeated overexpansion are potentially contributed to stent fracture. Conclusion: Selecting suitable stents, avoiding repeated overexpansion, controlling of hypertension and smoking cessation may decrease stent fracture and avoid vertebral artery restenosis after endovascular intervention.