医学
再狭窄
狭窄
翼展
支架
颈内动脉
优势比
血管成形术
冲程(发动机)
经皮
病变
心脏病学
外科
放射科
内科学
航空航天工程
空气动力学
工程类
机械工程
作者
Aquilla S Turk,Elad I. Levy,Felipe C. Albuquerque,G. L. Pride,Henry H. Woo,Babu G. Welch,David B. Niemann,Phillip D. Purdy,Beverly Aagaard-Kienitz,Peter A. Rasmussen,L. N. Hopkins,Thomas J. Masaryk,Cameron G. McDougall,David Fiorella
出处
期刊:American Journal of Neuroradiology
[American Society of Neuroradiology]
日期:2008-01-01
卷期号:29 (1): 23-27
被引量:180
摘要
Wingspan is a self-expanding, microcatheter-delivered microstent specifically designed for the treatment of symptomatic intracranial atherosclerotic disease. Our aim was to discuss the effect of patient age and lesion location on in-stent restenosis (ISR) rates after percutaneous transluminal angioplasty and stenting (PTAS) with the Wingspan system.Clinical and angiographic follow-up results were recorded for all patients from 5 participating institutions. ISR was defined as >50% stenosis within or immediately adjacent (within 5 mm) to the implanted stent and >20% absolute luminal loss. For the present analysis, patients were stratified into younger (=55 years) and older (>55 years) age groups.ISR occurred at a rate of 45.2% (14/31) in the younger group and 24.2% (15/62) in the older group (odds ratio, 2.6; 95% confidence interval, 1.03-6.5). In the younger group, ISR occurred after treatment of 13/26 (50%) anterior circulation lesions versus only 1/5 (20%) posterior circulation lesions. In the older group, ISR occurred in 9/29 (31.0%) anterior circulation lesions and 6/33 (18.2%) posterior circulation lesions. In young patients, internal carotid artery lesions (10/17 treated, 58.8%), especially those involving the supraclinoid segment (8/9, 88.9%), were very prone to ISR. When patients of all ages were considered, supraclinoid segment lesions had much higher rates of both ISR (66.6% versus 24.4%) and symptomatic ISR (40% versus 3.9%) in comparison with all other locations.Post-Wingspan ISR is more common in younger patients. This increased risk can be accounted for by a high prevalence of anterior circulation lesions in this population, specifically those affecting the supraclinoid segment, which are much more prone to ISR and symptomatic ISR than all other lesions.
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