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Objective@#: Covered stenting is an optional strategy for traumatic carotid pseudoaneurysm, especially in malignant conditions of potential rupture, but the long-term outcomes are not clear. Our aim was to determine if covered stenting is an effective option for traumatic carotid pseudoaneurysm with promising long-term outcomes. @*Methods@#: Self-expanding Viabahn and balloon-expandable Willis covered stents were separately implanted for extra- and intracranial traumatic carotid pseudoaneurysm. The covered stent was placed across the distal and proximal pseudoaneurysm leakage under roadmap guidance. Procedural success was defined as technical success (complete exclusion of the pseudoaneurysm and patency of the parent artery) without a primary end point (any stroke or death within 30 days after the procedure). Longterm outcomes were evaluated as ischemic stroke in the territory of the qualifying artery by clinical follow-up through outpatient or telephone consultation and as the exclusion of the pseudoaneurysm and patency of the parent artery by imaging follow-up through angiography. @*Results@#: Five patients with traumatic carotid pseudoaneurysm who underwent covered stenting were enrolled. The procedural success rate was 100%. No ischemic stroke in the territory of the qualifying artery was recorded in any of the five patients during a mean clinical follow-up of 44±16 months. Complete exclusion of the pseudoaneurysm and patency of the parent artery were maintained in all five patients during a mean imaging follow-up of 39±16 months. @*Conclusion@#: Satisfactory procedural and long-term outcomes were obtained, suggesting that covered stenting is an effective option for traumatic carotid pseudoaneurysm.
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Objective To analyse the clinical effect of Quantianma capsules combined with flupentixol and melitracen tablets on chronic migraine. Methods 130 patients with chronic migraine were treated with flupentixol and melitracen tablets, were divided into control group and observation group, 65 patients in each group. The observation group were given to Quantianma capsules. Results The effective rate of observation group with 90.77% was higher than control group with 73.85%(P<0.05). After treatment, the number of migraine attacks, duration time, VAS score, HAMA and HAMD score and mean flow velocity of cerebral artery of two groups were lower than pre-treatment and observation group were lower than that of control group(P<0.05). Adverse reactions were similar in the two groups. Conclusion Quantianma capsules can improve the efficacy of treatment of chronic migraine combined with flupentixol and melitracen tablets and improve condition with few adverse effects.
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Objective To analyse the clinical effect of Quantianma capsules combined with flupentixol and melitracen tablets on chronic migraine. Methods 130 patients with chronic migraine were treated with flupentixol and melitracen tablets, were divided into control group and observation group, 65 patients in each group. The observation group were given to Quantianma capsules. Results The effective rate of observation group with 90.77% was higher than control group with 73.85%(P<0.05). After treatment, the number of migraine attacks, duration time, VAS score, HAMA and HAMD score and mean flow velocity of cerebral artery of two groups were lower than pre-treatment and observation group were lower than that of control group(P<0.05). Adverse reactions were similar in the two groups. Conclusion Quantianma capsules can improve the efficacy of treatment of chronic migraine combined with flupentixol and melitracen tablets and improve condition with few adverse effects.
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<p><b>BACKGROUND</b>There are few studies for evaluating plaque characteristics of nonstenotic basilar arteries (BA). Our aim was to determine entire BA plaques with a three-dimensional volumetric isotropic turbo spin-echo acquisition (VISTA) and investigate the differences between the patients with and without isolated pontine infarction (IPI).</p><p><b>METHODS</b>Twenty-four consecutive symptomatic patients with nonstenotic BA on time of flight magnetic resonance angiography (TOF MRA) were enrolled from China-Japan Friendship Hospital between January 2014 and December 2014. BA was classified as "normal" or "irregular" based on TOF MRA, and "normal wall", "slight wall-thickening", and "plaque" based on three-dimensional VISTA images. Outcomes from MRA and VISTA were compared. Patients were categorized as IPI and non-IPI groups based on the diffusion-weighted imaging. Clinical and plaque characteristics were compared between the two groups.</p><p><b>RESULTS</b>A total of 1024 image slices including 311 (30.37%) plaque slices, 427 (41.70%) slight wall-thickening slices, and 286 (27.93%) normal wall slices for the entire BA from 23 patients were finally included for analysis. VISTA images detected plaques in all the 9 (100%) irregular MRA patients and 7 of 14 (50%) normal MRA patients. IPI was found in 11 (47.83%) patients. Compared to non-IPI group, the IPI group had a higher percentage of plaque slices (P = 0.001) and lower percentage of normal wall slices (P = 0.014) than non-IPI group.</p><p><b>CONCLUSIONS</b>Three-dimensional VISTA images enable detection of BA plaques not visualized by MRA. BA plaques could be found in both the IPI and non-IPI group. However, IPI group showed plaques more extensively in BA than the non-IPI group.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Basilar Artery , Pathology , Magnetic Resonance Angiography , Magnetic Resonance Imaging , Methods , Plaque, Atherosclerotic , Pathology , Pons , PathologyABSTRACT
<p><b>BACKGROUND</b>There are few studies for evaluating wall characteristics of intracranial vertebral artery hypoplasia (VAH). The aim of this study was to determine wall characteristics of VAH with three-dimensional volumetric isotropic turbo spin echo acquisition (3D VISTA) images and differentiate between acquired atherosclerotic stenosis and VAH.</p><p><b>METHODS</b>Thirty patients with suspicious VAH by luminograms were retrospectively enrolled between January 2014 and February 2015. The patients were classified as "acquired atherosclerotic stenosis" or "VAH" based on 3D VISTA images. The wall characteristics of VAH were assessed to determine the presence of atherosclerotic lesions, and the patients were classified into two subgroups (VAH with atherosclerosis and VAH with normal wall). Wall characteristics of basilar arteries and vertebral arteries were also assessed. The clinical and wall characteristics were compared between the two groups.</p><p><b>RESULTS</b>Five of 30 patients with suspicious VAH were finally diagnosed as acquired atherosclerotic stenosis by 3D VISTA images. 25 patients were finally diagnosed as VAH including 16 (64.00%) patients with atherosclerosis and 9 (36.00%) patients with normal wall. In the 16 patients with atherosclerosis, plaque was found in 9 patients, slight wall thickening in 6 patients, and thrombus and wall thickening in 1 patient. Compared with VAH patients with normal wall, VAH patients with atherosclerosis showed atherosclerotic basilar arteries and dominant vertebral arteries more frequently (P = 0.000).</p><p><b>CONCLUSIONS</b>Three-dimensional VISTA images enable differentiation between the acquired atherosclerotic stenosis and VAH. VAH was also prone to atherosclerotic processes.</p>