ABSTRACT
Objective To explore the safety and effectiveness of stent angioplasty for acute intracranial large artery atherosclerosis occlusion. Methods We retrospectively analyzed the clinical data of 460 patients with acute ischemic stroke undergoing endovascular thrombectomy in our hospital from May 2013 to Feb. 2018. We selected the patients with stent angioplasty and evaluated the safety and effectiveness. Results Fifty-six patients were included in this study, and there were 36 cases (64.3%) with occlusion of the anterior circulation and 20 cases (35.7%) of the posterior circulation. Twenty patients underwent intravenous thrombolysis before operation, and the door-to-needle time was (39.9±13.2) min. All scaffolds were successfully released to the designated location with a technical success rate of 100% (56/56). Fifty-five patients (98.2%) achieved recanalization of modified thrombolysis in cerebral infarction grade 2b and 3, and one patient had failed recanalization. The National Institutes of Health stroke scale score was 2.0 (0.0, 6.0) at 7 d after operation, which was significantly improved compared with the preoperation one (12.5 [6.0, 20.0], Z＝－4.073, P0.05). Intracranial hemorrhage occurred in 7 patients (12.5%) after operation, in which 2 patients (3.6%) had symptomatic intracranial hemorrhage. Thirty-nine patients (69.6%) received skull computed tomography perfusion (CTP) examination at 3-5 d after operation, and CTP showed that 33 cases (84.6%) had patency, 4 cases (10.3%) had reocclusion, and 2 cases (5.1%) had moderate stenosis; and 17 cases (30.4%) were not examined by CTP. Thirty-four patients (60.7%) had a good prognosis at 90 d after operation (modified Rankin scale score 0-2), 9 (16.1%) died, and 13 (23.2%) were lost. Conclusion Stent angioplasty is a safe and effective treatment method for acute intracranial large artery atherosclerosis occlusion. However, short-term stent reocclusion after operation should not be ignored.
ABSTRACT
Objective To investigate the characteristics and risk factors of the cerebral artery atherosclerotic stenosis in patients aged 90 years and older. Methods A total of 92 patients,aged 90 years or older,admitted to our hospital from July 2009 to July 2014 were respec-tively enrolled in this study. All participants underwent CTA to assess the presence and severity of atherosclerotic stenosis with intracranial and extracranial cerebral artery. The association between atherosclerotic stenosis and related risk factors were analyzed. Results The preva-lence of cerebral artery atherosclerotic stenosis was high in the cohort. The frequency of stenosis with intracranial artery was higher than the frequency with extracranial artery (86. 2% vs 44. 8%). The most common positions of cerebral artery atherosclerotic stenosis were the middle cerebral artery (43. 1%),the posterior cerebral artery (43. 1%),and extracranial vertebral artery (32. 8%). The mean age,body mass in-dex,systolic and diastolic blood pressure,and fasting blood glucose of stenosis group are significantly different from the non-stenosis group in single factor analysis (P<0. 05). Multivariate Logistic regression analysis showed body mass index was the independent risk factor of cere-bral artery atherosclerotic stenosis(β=1. 326,OR=3. 765,P<0. 05). Conclusion The prevalence of cerebral artery atherosclerotic steno-sis was high in the patients aged 90 years and older. Body mass index was the independent risk factor. The weight control should be pay atten-tion to prevent cerebral artery atherosclerotic stenosis and stroke.