|
|
|
| Analysis of influencing factors of residual stenosis after carotid artery stent implantation |
| LI Run-xiong |
| Department of Neurology, Dongguan People′s Hospital of Guangdong Province |
|
|
|
|
Abstract Objective To analyze the influencing factors of residual stenosis after carotid artery stent implantation.Methods Data of 152 patients with carotid artery stenosis (173 stents in total) who received carotid artery stent implantation in Dongguan People′s Hospital from February 2016 to February 2019 were retrospectively analyzed. Carotid angiography and color Doppler flow imaging (CDFI) were performed within 2 weeks before surgery, and CDFI was performed within 7 days after surgery. Patients were divided into residual stenosis group (n=36) and non-residual stenosis group (n=116) according to whether residual stenosis occurred after carotid artery stent implantation. The incidence of residual stenosis after carotid stenting was calculated. The clinical data and therapeutic effect of patients in residual stenosis group and non-residual stenosis group were compared. The influence of different structure characteristics of carotid artery stenosis on the incidence of residual stenosis after carotid stent implantation were analyzed. Multivariate Logistic analysis was used to investigate the risk factors for residual stenosis after carotid artery stenting. Results In 152 patients, the incidence of residual stenosis after carotid stenting was 23.68% (36/152), and 50 stents were inserted. The prevalence of hypertension in the residual stenosis group was 75.00%, higher than that in the non-residual stenosis group (64.66%), with a statistically significant difference (P<0.05). The total effective rate of the residual stenosis group was 97.22%, higher than that of the nonresidual stenosis group (81.90%), and the difference was statistically significant (P<0.05). There were no statistically significant differences in the incidence rates of residual stenosis after carotid artery stent implantation among patients with different stent locations, echo levels, and plaque calcification (P>0.05). Patients with preoperative vascular diameter <1.0 mm, heterogeneous echogenic plaque, surface calcification plaque, irregular plaque, and high grade of preoperative carotid artery contrast-enhanced ultrasound had higher incidence of residual stenosis after carotid stent implantation, and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that hypertension (β=0.38, OR=1.48, 95%CI=0.90-2.38), preoperative vascular diameter < 1.0 mm (β=0.46, OR=1.60, 95%CI=1.05-2.43), surface calcified plaque (β=0.92, OR=2.54, 95%CI=1.46-4.48), irregular plaque (β=2.17, OR=9.01, 95%CI=5.20-15.58), and high grade of preoperative carotid artery contrast-enhanced ultrasound (β=0.65, OR=1.24, 95%CI=1.15-2.77) were risk factors for residual stenosis after carotid stent implantation (P<0.05). Conclusion Carotid stenosis in patients with vascular structure characteristics (such as preoperative blood vessel diameter, surface calcified plaque, irregular plaques, preoperative carotid ultrasound imaging classification, etc.) are the carotid stent implantation factors that influence the incidence of residual stenosis after carotid artery stent implantation. Therefore, it is recommended to select an appropriate way to treat patients with carotid artery stenosis in combination with imaging features.
|
|
|
|
|
|
| [1] |
肖罡，刘保国，何黎明，等.颈动脉支架成形术后再狭窄血清相关性指标探讨[J].深圳中西医结合杂志，2016，26（20）：85-86.
|
| [2] |
元艳.颈内动脉狭窄程度与颈动脉支架成形术后低血压相关性观察与护理[J].天津护理，2016，24（5）：410-411.
|
| [3] |
宋则周，张艳明，傅燕飞，等.超声造影评估颈动脉斑块增强类型与脑梗死灶体积的关系[J].中华超声影像学杂志，2014，23（6）：539-541.
|
| [4] |
林玲，张梅，邱逦，等.颈动脉粥样硬化斑块新生血管的超声造影强化特征研究[J].四川大学学报（医学版），2014，45（6）：992-996.
|
| [5] |
陶昀璐，华扬，焦力群，等.超声评估颈动脉支架植入术后残余狭窄的影响因素[J].中华神经外科杂志，2018，34（5）：495-499.
|
| [6] |
于志强.颈动脉内膜切除术与颈动脉支架成形术治疗症状性颈动脉极重度狭窄的效果及安全性[J].中国实用医刊，2019，46（13）：30-32.
|
| [7] |
夏莉莉.超声波技术对颈动脉狭窄介入治疗前后的检测分析和评价[J].大家健康旬刊，2016，10（12）：57-58.
|
| [8] |
高宝云.血管内支架成形术治疗老年颈动脉狭窄患者的体会[J].中国医学工程，2016，10（9）：111-112.
|
| [9] |
徐文柱.经皮血管内成形及支架植入术治疗脑梗死伴重度颈动脉狭窄的可行性及安全性[J].医学理论与实践，2016，29（19）：3341-3342.
|
| [10] |
刘华坤，张磊，闫中瑞，等.伴有同侧颈内动脉狭窄或闭塞的进展性分水岭梗死的颈动脉支架植入术治疗[J].国际脑血管病杂志，2016，24（3）：214-218.
|
| [11] |
张鹏飞，赵立文，汪子文，等.内膜斑块剥脱术与支架植入术治疗颈动脉狭窄的Meta 分析[J].中国临床神经外科杂志，2016，7（8）：455-457.
|
| [12] |
王根，曹毅.颈动脉支架植入术后再狭窄的病理生理学机制[J].国际脑血管病杂志，2016，24（10）：936-939.
|
| [13] |
陈胜江，尚智伟，申东彦，等.颈动脉狭窄支架植入术后不同疗效患者术前超声参数的比较[J].中华血管外科杂志，2017，2（3）：160-163.
|
| [14] |
陈宇，刘昌伟，刘志丽，等.颈动脉内膜剥脱术和颈动脉支架的疗效分析[J].中国卒中杂志，2016，11（7）：536-541.
|
| [15] |
霍颖超，严家川，周华东，等.颅外颈动脉和椎动脉狭窄支架植入术围术期并发症及危险因素分析[J].中华老年心脑血管病杂志，2016，18（11）：1124-1128.
|
|
|
|
