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Inspiration from SAMMPRIS Trial

Inspiration from SAMMPRIS Trial. 对颅内动脉支架治疗的反思. 第三军医大学附属新桥医院神经内科. 重庆 400037. 帅杰 neurosj@hotmail.com. SAMMPRIS Trial S tenting and A ggressive M edical M anagement for P reventing R ecurrent stroke in I ntracranial S tenosis 支架 ( Wingspan)+. 积极药物治疗. 积极药物治疗. 主要终点:.

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Inspiration from SAMMPRIS Trial

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  1. Inspiration from SAMMPRIS Trial 对颅内动脉支架治疗的反思 第三军医大学附属新桥医院神经内科 重庆 400037 帅杰 neurosj@hotmail.com

  2. SAMMPRIS Trial Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis 支架 (Wingspan)+ 积极药物治疗 积极药物治疗

  3. 主要终点: *: fewer than half the patients have been followed for one year Source: Fiorella, D. Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis: 30-Day Results of the SAMMPRIS Trial, SNIS Annual Meeting, July 2011.

  4. 支架治疗在防止30天后的致死及致残性卒中担当重要角色, 如果能保证围手术期 后主要并发症风险控制在可以接受的水平,那么支架治疗的作业会是怎样的呢? *SAMMPRIS 平均随访时间:11.9M

  5. Wingspan支架治疗症状性重度颅内狭窄结果的系统性回顾Wingspan支架治疗症状性重度颅内狭窄结果的系统性回顾 姜卫剑教授Stroke published online Jun2,2011 • • 研究背景及目的: Wingspan支架治疗症状性重度颅内狭窄的长期随访结果非常有限。通过我们中心的Wingspan支架组的数据与WASID历史 数据相对照,我们来检验那种对高危病人来说,与单纯的抗血栓药物治疗相比,支架治疗是无益的假说。 • • • • • 研究对象: 2007年1月至2009年2月颅内动脉粥样硬化狭窄>=70%,症状在90天内的100例病人使用Wingspan支架治疗,其主要研究 终点(30天内的卒中及死亡、同侧缺血性卒中)一年的风险与WASID重度狭窄病人对照。 结果: 支架组的30天内的卒中及死亡、加上30天后的同侧卒中,一年累计概率为7.3%,低于WASID中同类病人18%,P<0.05

  6. CASE 1 很一般般的手术,关键是手术者要 知道是要解决什么问题!

  7. CT angiography

  8. Perfusion CT

  9. CTA assists PTAS design

  10. PTAS Wingspan 2.5*9mm

  11. CASE 2 手术者要在术前明确支架治疗重要的是 解决什么问题?

  12. CASE 3 支架技术决定了术后是否出现穿支事件

  13. 技术+认识

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