[1]沈 寻,王文蕾,秦怀海,等.Neuroform EZ支架辅助颅内动脉瘤栓塞后动脉内膜增生的动态演化规律[J].介入放射学杂志,2023,32(01):48-54.
 SHEN Xun,WANG Wenlei,QIN Huaihai,et al.The dynamic evolution of the arterial intimal hyperplasia after Neuroform EZ stent-assisted treatment of intracranial aneurysms[J].journal interventional radiology,2023,32(01):48-54.
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Neuroform EZ支架辅助颅内动脉瘤栓塞后动脉内膜增生的动态演化规律()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年01
页码:
48-54
栏目:
临床研究
出版日期:
2023-02-13

文章信息/Info

Title:
The dynamic evolution of the arterial intimal hyperplasia after Neuroform EZ stent-assisted treatment of intracranial aneurysms
作者:
沈 寻 王文蕾 秦怀海 郝伟丽 张学敬 高不郎
Author(s):
SHEN Xun WANG Wenlei QIN Huaihai HAO Weili ZHANG Xuejing GAO Bulang.
Department of Neurosurgery, Emergency General Hospital, Beijing 100028, China
关键词:
【关键词】颅内动脉瘤支架辅助栓塞载瘤动脉支架内狭窄Neuroform EZ支架
文献标志码:
A
摘要:
【摘要】 目的 对接受Neuroform EZ支架辅助栓塞治疗的颅内宽颈动脉瘤患者载瘤动脉直径进行准确测量,以明确载瘤动脉对支架植入的反应。方法 纳入87例患者100枚颅内未破裂动脉瘤,均行Neuroform EZ支架辅助栓塞治疗及高分辨率3D旋转血管造影。采用亚毫米级3D形态测量分析系统Amira成像软件对植入支架前后载瘤动脉直径和横截面积(CSA)进行测量和分析。结果 支架植入即刻与植入前相比,载瘤动脉D点直径(增大0.18 mm或16.0%)、E点直径(增大0.09 mm或3.2%)显著增大(均P<0.01)。初期血管造影随访中,与支架植入即刻相比,载瘤动脉平均直径在A点(缩小0.21 mm或5.7%)、B点(缩小0.50 mm或14.1%)、D点(缩小0.44 mm或14.0%)、E点(缩小0.29 mm或10.7%)显著缩小(均P<0.01)。末次血管造影随访中,支架内狭窄自行消失,血管直径恢复到支架植入即刻水平。载瘤动脉CSA百分比变化显示,支架植入4个月时开始下降,6个月时逐渐增大,直至恢复至植入即刻初始水平。结论 Neuroform EZ支架辅助栓塞颅内动脉瘤时支架植入段动脉会发生动态、可逆的内膜增生和再狭窄反应。该发现可用于支架直径选择和抗凝药物应用,以降低支架植入不良反应,提高疗效。

参考文献/References:

[1] Kim C, Lee SG, Lim S, et al. A senolytic-eluting coronary stent for the prevention of in-stent restenosis[J]. ACS Biomater Sci Eng, 2022, 8: 1921-1929.
[2] Li M, Hou J, Gu X,et al. Incidence and risk factors of in-stent restenosis after percutaneous coronary intervention in patients from southern China[J]. Eur J Med Res, 2022, 27:12.
[3] Clare J, Ganly J, Bursill CA, et al. The mechanisms of restenosis and relevance to next generation stent design[J]. Biomolecules, 2022, 12:430.
[4] Rai AT, Turner RC, Brotman RG, et al. Comparison of operating room variables, radiation exposure and implant costs for WEB versus stent assisted coiling for treatment of wide neck bifurcation aneurysms[J]. Interv Neuroradiol, 2021, 27: 465-472.
[5] Xue G, Zuo Q, Zhang X, et al. Safety and efficacy of stent-assisted coiling for acutely ruptured wide-necked intracranial aneurysms: comparison of LVIS stents with laser-cut stents[J]. Chin Neurosurg J, 2021, 7: 19.
[6] 白京岳,孟庆斌,王子博,等. 颈内动脉-后交通动脉瘤常规支架辅助弹簧圈栓塞治疗临床结果及复发因素分析[J]. 介入放射学杂志,2021,30:1095-1099.
[7] 陈炳基,蒋小燕,冯 睿,等. 支架辅助弹簧圈栓塞治疗宽颈肾动脉瘤临床效果观察[J]. 介入放射学杂志,2021,30:336-339.
[8] 倪 恒,刘 圣,赵林波,等. Neuroform EZ支架辅助弹簧圈栓塞治疗颈内动脉眼动脉段动脉瘤中远期安全性和有效性分析[J]. 介入放射学杂志,2021,30:537-541.
[9] Gao X, Liang G, Li Z, et al. Complications and adverse events associated with neuroform stent-assisted coiling of wide-neck intracranial aneurysms[J]. Neurol Res, 2011, 33:841-852
[10] Kulcsar Z, Goricke SL, Gizewski ER, et al. Neuroform stent- assisted treatment of intracranial aneurysms: long-term follow-up study of aneurysm recurrence and in-stent stenosis rates[J]. Neuroradiology, 2013, 55: 459-465.
[11] Wan H, Lu G, Huang L, et al. Comparison of solitaire and neuroform stenting for coiling of intracranial bifurcation aneurysms[J]. Interv Neuroradiol, 2022:15910199221081249.
[12] Gao B, Safain MG, Malek AM. Enterprise stenting for intracranial aneurysm treatment induces dynamic and reversible age-dependent stenosis in cerebral arteries[J]. J Neurointerv Surg, 2015, 7: 297-302.
[13] Hoit DA, Malek AM. Three-dimensional rotational angiographic detection of in-stent stenosis in wide-necked aneurysms treated with a self-expanding intracranial stent[J]. Neurosurgery, 2005,57:1228-1236.
[14] Jakubiak GK, Pawlas N, Cieslar G, et al. Pathogenesis and clinical significance of in-stent restenosis in patients with diabetes [J]. Int J Environ Res Public Health, 2021 ,18:11970.
[15] Shlofmitz E, Iantorno M, Waksman R. Restenosis of drug-eluting stents: a new classification system based on disease mechanism to guide treatment and state-of-the-art review[J]. Circ Cardiovasc Interv, 2019, 12:e007023
[16] Jou LM, Jou LD, Mawad ME. Hemodynamic effect of neuroform stent on intimal hyperplasia and thrombus formation in a carotid aneurysm[J]. Med Eng Phys, 2011, 33: 573-580.
[17] Saito N, Mori Y, Komatsu T. Influence of stent flexibility on artery wall stress and wall shear stress in bifurcation lesions[J]. Med Devices (Auckl), 2020, 13: 365-375.
[18] Gunn J, Arnold N, Chan KH, et al. Coronary artery stretch versus deep injury in the development of in-stent neointima[J]. Heart, 2002, 88: 401-405.
[19] Berry JL, Santamarina A, Moore JE Jr, et al. Experimental and computational flow evaluation of coronary stents[J]. Ann Biomed Eng, 2000, 28:386-398.
[20] Greil O, Kleinschmidt T, Weiss W,et al. Flow velocities after carotid artery stenting: impact of stent design. A fluid dynamics study in a carotid artery model with laser doppler anemometry[J]. Cardiovasc Intervent Radiol, 2005, 28:66-76
[21] Fiorella D, Albuquerque FC, Woo H, et al. Neuroform in-stent stenosis: incidence, natural history, and treatment strategies[J]. Neurosurgery, 2006, 59:34-42.
[22] Hasanefendioglu A, Bayrak B, Kocer N, et al. Regression of neointimal hyperplasia of an intracranial stent: 6 years follow-up of a wide-necked aneurysm[J]. Turk Neurosurg, 2010, 20: 90-95.
[23] Asakura M, Ueda Y, Nanto S, et al. Remodeling of in-stent neointima, which became thinner and transparent over 3 years: serial angiographic and angioscopic follow-up[J]. Circulation, 1998, 97: 2003-2006.
[24] Hermiller JB, Fry ET, Peters TF, et al. Late coronary artery stenosis regression within the gianturco-roubin intracoronary stent[J]. Am J Cardiol, 1996, 77: 247-251.
[25] Mikuriya Y, Wakayama K, Kadota M, et al. Long-term angiographic follow-up results in patients undergoing percutaneous transluminal coronary angioplasty[J]. Jpn Circ J, 1989, 53: 728- 734.
[26] Rosing DR, Cannon RO 3rd, Watson RM, et al. Three year anatomic, functional and clinical follow-up after successful percutaneous transluminal coronary angioplasty[J]. J Am Coll Cardiol, 1987, 9:1-7.
[27] Haidegger M, Kneihsl M, Niederkorn K, et al. Blood biomarkers of progressive atherosclerosis and restenosis after stenting of symptomatic intracranial artery stenosis[J].Sci Rep, 2021, 11:15599
[28] Kimura T, Abe K, Shizuta S, et al. Long-term clinical and angiographic follow-up after coronary stent placement in native coronary arteries[J]. Circulation, 2002, 105: 2986-2991.
[29] Nobuyoshi M, Kimura T, Ohishi H, et al. Restenosis after percutaneous transluminal coronary angioplasty: pathologic observations in 20 patients[J]. J Am Coll Cardiol, 1991, 17: 433-439.

相似文献/References:

[1]张荣举,王君,吕斌,等.Neuroform EZ支架治疗颅内动脉瘤安全有效性单中心观察 [J].介入放射学杂志,2020,29(03):228.
 ZHANG Rongju,WANG Jun,LÜ,et al. The safety and effectiveness of Neuroform EZ stent in the treatment of intracranial aneurysms: a single-center observation study[J].journal interventional radiology,2020,29(01):228.

备注/Memo

备注/Memo:
(收稿日期:2021-08-07)
(本文编辑:边 佶)  
更新日期/Last Update: 2023-02-13