河北医科大学学报 ›› 2025, Vol. 46 ›› Issue (6): 676-681.doi: 10.3969/j.issn.1007-3205.2025.06.009

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药物洗脱支架与裸金属支架治疗症状性椎动脉狭窄的临床研究

  

  1. 1.河北医科大学第一医院神经外科,河北 石家庄 050031;2.河北医科大学第一医院神经内科,河北 石家庄 050031

  • 出版日期:2025-06-25 发布日期:2025-07-04
  • 作者简介:贾博(1995-),男,河北邢台人,河北医科大学第一医院医学硕士研究生,从事神经外科疾病诊治研究。

  • 基金资助:
    国家卫生健康委能力建设和继续教育中心资助项目(GWJJQ2022100102)

Clinical study on the treatment of symptomatic vertebral artery stenosis with drug-eluting stents versus bare-metal stents

  1. 1.Department of Neurosurgery, the First Hospital of Hebei Medical University, Shijiazhuang 
    050031, China; 2.Department of Neurology, the First Hospital of Hebei Medical University, 
    Shijiazhuang 050031, China

  • Online:2025-06-25 Published:2025-07-04

摘要: 目的探究药物洗脱支架与裸金属支架治疗椎动脉狭窄的安全性、有效性及支架内再狭窄的影响因素。
方法选取2022年6月—2023年10月在河北医科大学第一医院神经外科行椎动脉支架植入术的患者129例,采用随机对照的方法分为药物洗脱支架组和裸金属支架组并进行随访,记录患者临床资料并根据术后是否发生支架内再狭窄分为狭窄组和非狭窄组。通过Logistic回归分析,分析影响支架内再狭窄的危险因素。
结果所有支架均成功植入,手术后无穿刺部位血肿、颅内出血或死亡事件发生。药物洗脱支架组的支架内再狭窄发生率显著低于裸金属支架组(4.84%% vs. 28.36%,P<0.05)。多因素Logistic回归分析证实裸金属支架组是支架内再狭窄的独立危险因素(OR=0.10,P<0.001,95%CI:0.02~0.39)。
结论椎动脉支架植入是治疗药物控制欠佳的症状性椎动脉狭窄患者的安全有效的方法,药物洗脱支架可以显著降低支架内再狭窄的发生率。


关键词: 椎底动脉供血不足, 支架内再狭窄, 药物洗脱支架

Abstract: Objective To explore the safety and efficacy of drug-eluting stents (DES) and bare-metal stents (BMS) in the treatment of vertebral artery stenosis (VAS), as well as the influencing factors of in-stent restenosis (ISR). 
Methods From June 2022 to October 2023, 129 patients undergoing vertebral artery stent implantation in the Department of Neurosurgery, the First Hospital of Hebei Medical University were selected and randomly divided into the DES group and the BMS group using a randomized controlled method and followed up. The clinical data of the patients were recorded and they were divided into the stenosis group and the non-stenosis group according to occurrence of ISR after surgery. Through Logistic regression analysis, the risk factors affecting ISR were analyzed. 
Results All stents were successfully implanted, and there was no hematoma at puncture site, intracranial hemorrhage, or death events after surgery. The incidence of ISR in the DES group was significantly lower than that in the BMS group (4.84% vs. 28.36%, P<0.05). Multivariate regression analysis confirmed that the BMS group was an independent risk factor for ISR (OR=0.10, P<0.001, 95%CI:0.02-0.39). 
Conclusion Vertebral artery stent implantation is a safe and effective method for treating patients with symptomatic VAS who are poorly controlled by drugs, and DES can significantly reduce the incidence of ISR. 


Key words: vertebrobasilar insufficiency, in-stent restenosis, drug-elutingstent