| Objective: To compare the efficacy and safety of domestic purple smoke DCB(Drug Coated Balloon)with traditional stents in the treatment of intracranial atherosclerotic stenosis.Research methods: According to the inclusion criteria and exclusion criteria,a total of 47 patients who underwent angioplasty due to intracranial atherosclerotic stenosis(ICAS)in our hospital from September 2020 to March 2022 were retrospectively randomly selected.According to the different surgical methods,domestic purple tobacco DCB was applied in the DCB group,while common stents were applied in the P TAS group.They were further divided into DCB group and PTAS group.Relevant baseline data and preoperative clinical data(preoperative imaging data,preoperative NIHSS score,preoperative laboratory examination)were collected.Intraoperative recanalizati on;Postoperative clinical data(postoperative m RS Score,postoperative laboratory examination and postoperative imaging review)were recorded in detail before,after and at follow-up(median follow-up time of 206(180,210)days in DCB group and 224(178,2 95)days in PTAS group).The incidence of restenosis at follow-up;TLR(Target Lesion Revascularization rate)and m RS After follow-up.The incidence of adverse events during perioperative period and follow-up were recorded in the two groups.The above data were statistically analyzed to evaluate the efficacy and safety between the two groups.Results: A total of 47 ICAD patients,19 in DCB group and 28 in PTAS group were enrolled for endovascular therapy.(1)There were no statistically significant differen ces in baseline data,previous diseases,smoking and drinking history,cardiovascular history,admissions,distribution of diseased vessels,length of diseased vessels,and preoperative target vessel stenosis rate between the two groups(p > 0.05).(2)The median follow-up time of patients in the DCB group was 206(180,210)days,and that of patients in the PTAS group was 224(178,295)days.There was no statistical difference in the median follow-up time between the two groups.One patient in the DCB group was restenosis(1/19,5.3%)at the time of follow-up.There were 8 patients(8/28,28.6%)with restenosis in the PTAS group,and the restenosis incidence in the DCB group was significantly lower than that in the PTAS group(P < 0.05).At follow-up,the mean degree of target vessel stenosis in DCB group was significantly lower than that in PTAS group(7.14±13.44 vs 33.82±32.20,p=0.001).No TLR occurred in DCB group(0/19,0%),and 4 patients(4/28,14.3%)in PTAS group.There was no significant difference betw een the two(p > 0.05).At follow-up,there was no significant difference in the rate of target vessel stenosis between the DCB group and the PTAS group(21.65±13.44 vs 33.82±32.20,p=0.147).(3)No recurrent ischemia events occurred in the DCB group(0/19,0%),and in the PTAS group(5/28,17.9%),there was no statistical difference between the two(p=0.051).Perioperative complications occurred in 2 patients(2/19,10.6%)in DCB group and 3 patients(3/28,10.7%)in PTAS group,showing no statistical differen ce between the two groups(p=0.984).(4)There were no significant differences in m RS Scores and related laboratory tests before,after and during follow-up between the two groups(p > 0.05).Conclusions:(1)Domestic purple tobacco drug balloon angioplast y and stent angioplasty are safe and effective for the treatment of ICAS patients who did not respond to intensive medical treatment,and both have good prognosis and clinical outcome.(2)Compared with stent implantation,domestic purple tobacco DCB has s ignificantly lower progression of lumen stenosis in short-term follow-up,and can significantly reduce the incidence of late restenosis.(3)DCB has no obvious advantage over stents in symptomatic restenosis and reducing perioperative complications.(4)DC B is promising in reducing the incidence of postoperative ischemic events and reducing TLR. |
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