Clinical Research
Enterprise 1 stent and Enterprise 2 stent in treating symptomatic intracranial atherosclerosis stenosis: a comparative study
Long Shuhai, Shi Shuailong, Yu Sun, Shi Chengcheng, Ma Ji, Yang Jie, Han Xinwei, Li Tengfei
Published 2023-03-15
Cite as Chin J Neuromed, 2023, 22(3): 231-239. DOI: 10.3760/cma.j.cn115354-20220803-00546
Abstract
ObjectiveTo compare the efficacies of Enterprise 1 stent and Enterprise 2 stent in treating symptomatic intracranial atherosclerotic stenosis (ICAS).
MethodsFrom January 2018 to April 2021, 76 patients with symptomatic ICAS treated by Enterprise 2 stent (implanting Enterprise 2 stents, EP2 group) and 52 patients with symptomatic ICAS treated with Enterprise 1 stent (implanting Enterprise 1 stents, EP1 group) were chosen from Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University. DSA was performed immediately after stent implantation and residual vascular stenosis rate was analyzed and compared between the 2 groups. Stent apposition of the 2 groups were evaluated according to reconstruction images of high-resolution flat detector CT; patients were divided into incomplete stent apposition (ISA) group and complete stent apposition group, accordingly; their clinical data were compared. Multivariate Logistic regression was used to analyze the independent influencing factors for ISA. Incidences of perioperative complications and short-term in-stent restenosis (6 months after implantation) in the EP2 group and EP1 group were observed.
ResultsIntracranial stent was successfully implanted in all patients, with technical success rate of 100%. Significant difference was noted in EP1 group between pre-implanted vascular stenosis rate (80.85±12.14)% and post-implanted residual vascular stenosis rate ([21.44±8.11]%, P<0.05); significant difference was noted in EP2 group between pre-implanted vascular stenosis rate (81.83±12.85)% and post-implanted residual vascular stenosis rate ([21.53±7.76]%, P<0.05); no significant difference was noted in pre-implanted vascular stenosis rate, post-implanted residual stenosis rate, or angles of stent between EP1 group and EP2 group (P>0.05). According to high-resolution flat detector CT scan, the ISA incidence in EP2 group (10.5%) was significantly lower than that in EP1 group (25.0%, P<0.05); compared with the complete stent apposition group, the ISA group had significantly higher post-implanted residual stenosis rate, higher proportions of patients with calcification at the stenosis, larger angles of stent, higher diameter ratio of anterior and posterior vessels of the stenosis lesions, and lower proportion of patients with Enterprise 2 stent implantation (P<0.05). Multivariate Logistic regression analysis showed that the angle of stents, diameter ratio of anterior and posterior vessels of the stenosis lesions and Enterprise 2 stent implantation were independent influencing factors for stent apposition; and Enterprise 2 stent implantation was an proactive factor for complete stent apposition. Perioperative complication rate showed significant difference between EP1 group and EP2 group (1.3% vs. 7.7%, P<0.05). Short-term in-stent restenosis between EP2 group and EP1 group was significantly different (26.1% vs. 7.0%, P<0.05).
ConclusionCompared with Enterprise 1 stent, Enterprise 2 stent has better apposition, higher safety, and lower incidence of short-term in-stent restenosis, enjoying clinical application value in treating symptomatic ICAS.
Key words:
Enterprise stent; Symptomatic intracranial atherosclerosis stenosis; High-resolution flat detector CT; Apposition
Contributor Information
Long Shuhai
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China
Shi Shuailong
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China
Yu Sun
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China
Shi Chengcheng
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China
Ma Ji
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China
Yang Jie
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China
Han Xinwei
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China
Li Tengfei
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Interventional Institute of Zhengzhou University, Zhengzhou 450052, China