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目的评价年龄≥70岁颅外段脑动脉狭窄患者血管内支架治疗的安全性和疗效。方法回顾性分析颅外段脑动脉狭窄患者323例,根据年龄分为≥70岁组117例,<70岁组206例,对比分析2组患者支架置入术后,支架置入成功率、围术期并发症及随访期间支架置入后再狭窄率和临床终点事件。结果≥70组与<70岁组支架治疗成功率均为100.0%,≥70岁组与<70岁组围术期并发症发生率分别为9.4%和7.3%,差异无统计学意义(χ~2=0.453,P=0.501)。术后随访期间,≥70岁组与<70岁组支架置入后动脉再狭窄率分别为12.0%和10.7%,差异无统计学意义(χ~2=0.585,P=0.445),≥70岁组临床终点事件发生率明显高于<70岁组,差异有统计学意义(18.8%vs 11.2%,χ~2=4.000,P=0.045),但生存率明显低于<70岁组(χ~2=7.581,P=0.006)。结论年龄≥70岁的老年症状性脑动脉狭窄患者支架置入是安全、有效的治疗策略。
Objective To evaluate the safety and efficacy of endovascular stenting in patients with extracranial cerebral artery stenosis of 70 years or older. Methods A total of 323 patients with extracranial cerebral artery stenosis were retrospectively analyzed. According to their age, 117 patients were aged ≥70 years and 206 patients were aged <70 years. The success rate of stent implantation was compared between the two groups after stent implantation. Postoperative complications and restenosis rate and clinical endpoint after stent implantation during follow-up. Results The success rate of stent treatment was 100.0% in ≥70 group and <70 years group, and the incidence of perioperative complications was ≥ 9.4% and 7.3% in ≥70 years and <70 years group, respectively, with no significant difference (χ ~ 2 = 0.453, P = 0.501). During postoperative follow-up, the rates of restenosis after stent placement were 12.0% and 10.7% in patients ≥70 years and <70 years, respectively, with no significant difference (χ ~ 2 = 0.585, P = 0.445) The incidence of clinical endpoint was significantly higher than that of patients <70 years old (18.8% vs 11.2%, χ ~ 2 = 4.000, P = 0.045), but the survival rate was significantly lower than that of patients <70 years old (χ ~ 2 = 7.581, P = 0.006). Conclusion Stent implantation in elderly patients with symptomatic cerebral artery stenosis older than 70 years is a safe and effective treatment strategy.