Efficacy Analysis Of Drug-eluting Stents And Bare Metal Stents In The Treatment Of Vertebral Artery Ostium Stenosis

Objective : This study analyzed the clinical efficacy of drug-eluting stent and bare metal stent in the treatment of atherosclerotic stenosis of vertebral artery ostium,in order to provide experimental basis for the selection and application of stent implantation for vertebral artery ostium stenosis.Methods:Retrospective analysis was made on 251 patients with atherosclerotic stenosis at the opening of vertebral artery who were hospitalized in the Affiliated Hospital of Qingdao University from June 2015 to June 2021 and met the inclusion and exclusion criteria.They were divided into drug eluting stent group(115 cases)or bare metal stent group(136 cases)according to the different stent implantation in vertebral artery.During the treatment and follow-up process,7 patients in the drug eluting stent group were lost and 2 died from all causes,while 9 patients in the bare metal stent group were lost and 3 died from all causes.Ultimately,106 patients were included in the drug eluting stent group and 124 patients were included in the bare metal stent group.Main endpoint events:(1)Any stroke(ischemic/hemorrhagic stroke),ipsilateral transient ischemic attack(TIA),and death during the perioperative period(within 30 days after surgery);(2)Immediate residual stenosis rate after surgery,any stroke(hemorrhagic/ischemic stroke)or death in the target blood supply area within 6 or 12 months after surgery;(3)Stent restenosis occurred within 6 and 12 months after surgery.Secondary endpoint events:(1)Record the patient’s vascular stenosis rate and neurological function status at 6 months after surgery;(2)Record the vascular stenosis rate and neurological function status of the patient at 12 months after surgery;(3)Record the occurrence of postoperative complications in the patient.Results:The surgical success rate of patients in drug-eluting stent group and bare metal stent group was 100%,and there was no significant difference in the number of patients with stroke or death 30 days after surgery between the two groups(P>0.05);The proportion of patients with stroke or death 12 months after operation in the drug-eluting stent group was 2.83%.It was lower than 10.48% in bare metal stent group,7.55% in stent restenosis,and 24.19% in bare metal stent group(P<0.05).There was no significant difference between the drug-eluting stent group and the bare metal stent group in the rate of residual stenosis,stroke or death at 6months after operation(P>0.05);The in-stent restenosis rate in the drug-eluting stent group was not 4.72%,which was lower than that in the bare-metal stent group 12.90%(P<0.05).There was no significant difference between the drug-eluting stent group and the bare-metal stent group in the rate of vascular stenosis,the number of cases with m RS score≤2,and the number of cases with NIHSS score≤3(P>0.05).The rate of vascular stenosis in the drugeluting stent group was(22.16±4.71)% at 12 months after operation,which was lower than that in the bare metal stent group(24.25 ± 4.09)%(P<0.05);There was no significant difference in the number of patients with m RS score≤2 and NIHSS score≤3 in the drugeluting stent group and bare metal stent group 12 months after operation(P>0.05).Conclusion:1.Drug eluting stent or bare metal stent is a safe and effective therapy with high technical success rate for patients with vertebral artery stenosis;2.Drug eluting stents can significantly reduce the risk of stent restenosis compared with bare metal stents;3.Compared with bare metal stents,drug-eluting stents can reduce stroke or mortality in patients12 months after surgery.