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颈动脉次全闭塞者和严重狭窄患者行颈动脉支架术后的30d结果比较：一种倾向匹配分析。
背景与目的：
颈动脉次全闭塞是一种伴有完全或部分远端管腔塌陷和较差侧支循环的严重狭窄类型。本研究旨在分析这类患者行颈动脉支架后术后30d解决和10年长期随访的生存率。
方法：
我们使用了来自在2005年至2021年间，639名患者接受了789例颈动脉支架植入术。主要终点是颈动脉支架植入术后30天内的任何卒中或死亡。使用基于6个变量的倾向评分来匹配患者。
结论：
倾向评分匹配显示，CAS组有84名受试者，对照组有168名受试者。在匹配队列中，主要终点分别出现在CAS组和对照组分别为：7例(8.3%)和11例(6.6%)患者中(P=.611)。
在匹配队列中，次全闭塞组与对照组的5年和10年生存率为69.8%（95%可信区间，58.0%-78.8%）对77.3%（95%可信区间，70.0%-83.1%），53.3%对53.3（95%置信区间，39.9%-65.0%）对53.3（94%置信区间，44.5%-61.4%）（对数秩检验，P=0.798）。
结论：
与严重狭窄相比，ICA近闭塞患者颈动脉支架置入与30天中风或死亡风险增加无关。 两组颈动脉支架置入后10年的生存情况相似。
Comparison of 30-Day Outcomes
after Carotid Artery Stenting in
Patients with Near-Occlusion and
Severe Stenosis: A Propensity
Score Matching Analysis.
AJNR. American Journal of Neuroradiology 2022 Aug 18;
BACKGROUND AND PURPOSE: Carotid artery near-occlusion is a type of severe stenosis with complete or partial distal luminal collapse and intracranial collaterals. This study aimed to
compare 30-day outcomes and 10-year survival in patients undergoing carotid artery stenting for near-occlusion with a control group of patients with severe stenosis.
MATERIALS AND METHODS: We used data from
a registry of 639 patients who underwent 789carotid artery stenting procedures between 2005and 2021. The primary end point was any stroke or death within 30 days after carotid artery stenting.Patients were matched using propensity scores based on 6 variables.
RESULTS: Propensity score matching yielded 84subjects in the near-occlusion group matched with168 subjects in the control group. In the matched cohort, the primary end point occurred in 7(8.3%)and 11(6.6%) patients in the near-occlusion and control groups, respectively(P=.611). In the
unmatched cohort, the primary end point occurred in 7(8.3%) and 19(4.1%) patients(P=.101). Survival in the near-occlusion group versus the control group in the matched cohort at 5 and 10 years was69.8%(95%Cl,58.0%-78.8%)versus 77.3%(95%CI,70.0%-83.1%)and 53.3%(95% Cl,39.9%-65.0%)versus 53.3%(95% Cl,44.5%-61.4%)(log-rank,P=.798).
CONCLUSIONS: Carotid stent placement
in patients with ICA near-occlusion was not
associated with an increased 30-day risk of stroke or death compared with severe stenosis. Survival up to 10 years after carotid artery stenting was similar in both groups.
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