ABSTRACT
Objective:To analyze the clinical efficacy and safety of stent implantation combined with drug therapy and drug therapy alone in patients with vertebral artery initial stenosis.Methods:A total of 112 patients with vertebral artery initial stenosis who were treated in Wuzhou Workers′ Hospital from January 2016 to June 2018 were selected and divided into drug group and stent + drug group according to random number table method, with 56 patients in each group. The drug group received drug therapy alone, and stent + drug group received stent implantation combined with drug therapy. The incidence of ischemic events in posterior circulation, the improvement of vascular stenosis rate and the improvement of neurological function injury were observed in the two groups after 12 months of treatment.Results:The success rate in the stent + drug group was 100.0%(56/56). The rate of vascular stenosis in the stent + drug group was lower than that in the drug group: (15.21 ± 3.74)% vs. (18.62 ± 4.27)% ; but the incidence of restenosis was higher than that in the drug group:26.79%(15/56) vs. 7.14%(4/56), the differences were statistically significant ( P<0.05). The total incidence of ischemic events in the posterior circulation after treatment in the stent + drug group was lower than that in the drug group: 8.93%(5/56) vs. 28.57%(16/56), and the difference was statistically significant ( χ2 = 7.092, P = 0.008). After treatment, the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) in the stent + drug group were lower than those in the drug group: (2.30 ± 0.36) scores vs. (3.75 ± 0.52) scores, (4.11 ± 0.51) scores vs.(6.14 ± 0.57) scores, and the differences were statistically significant ( P<0.05). Conclusions:The application of stent implantation combined with drug regimen in the treatment of patients with vertebral artery initial stenosis can effectively reduce the neurological damage of patients, andimprove the total effective rate, which is conductive to the improvement of patients′ quality of life, but the rate of stent restenosis is high.
ABSTRACT
Objective To investigate the impact of collateral circulation on neurological function and prognosis outcome of patients with acute cerebral infarction. Methods Assessed the collateral circulation of 274 patients with acute cerebral infarction from June 2012 to April 2015 in the department of neurology in Worker′s Hospital of Wuzhou using DSA, analyzed patients′ neurological function and prognosis outcome concerning their collateral circulation. Results (1) Impairment of neurological function were different between collateral circulation group and non-collateral circulation group ( P 0.05). (2)14 and 90 days after treatment, symptoms of neurological impairment in posterior communicating artery, before pial artery, after pial artery and combination artery were significantly improved as with their NIHSS scores (P 0.05). Conclusions (1) Neurological function of patients with collateral circulation was better without collateral circulation. Grading of collateral circulation had did not relate to neurological function. (2) Prognosis of patients with collateral circulation was improved significantly than the patients without collateral circulation. The types of collateral circulation affect the prognosis of the patients with acute cerebral infarction.