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Objective To explore the predictors of perioperative ischemic stroke following percutaneous transluminal angioplasty and stenting.Methods We retrospectively evaluated data on 416 percutaneous transluminal angioplasty and stenting (PTAS) procedures at (334 males,82 females,aged 40-85 years,falling into ASA Ⅰ-Ⅲ) a single institution.Logistic regression was used to analyze the role of clinical,angiographic and hemodynamic variables on periprocedural ischemic strokes.Results Among 328 patients underwent PTAS for the treatment of extracranial stenosis,10 patients (3.0％) had perioperative ischemic stroke.Among the 88 stenting for intracranial stenosis,6 patients (6.8 ％) had perioperative ischemic stroke.Multivariable predictors of perioperative ischemic stroke for stenting for extracranial stenosis were the presence of untreated intracranial artery stenosis (OR =9.44,95％CI 2.36-37.71,P=0.001) and intraoperative absolute minimal SBP＜90 mm Hg (OR=9.13,95％CI 1.35-61.76,P =0.023).The independent predictors of perioperative ischemic stroke following PTAS for intracranial stenosis included the patients' increasing age (OR =1.25,95 ％ CI 1.04-1.51,P=0.021),presence of calcific plaques (OR=11.02,95％CI 1.11-109.25,P=0.040) and untreated intracranial artery stenosis (OR =44.81,95％ CI 1.99-1 011.84,P =0.017).Conclusion For patients with extracranial stenosis,suffering from the presence of untreated intracranial artery stenosis and intraoperative absolute minimal SBP＜90 mm Hg are the independent risk factors for perioperative ischemic stroke.The patients' increasing age,presence of calcific plaques and untreated intracranial artery stenosis were the independent risk factors for this complication in patients with intracranial stenosis.
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Objective To explore clinical characteristics of patients with cerebral infarction(CI) complicated with metabolic syndrome(MS) and their correlation with severity of cerebrovascular stenosis. Methods A total of 585 cases with CI were retrospectively studied. The patients were catogorized in to groups with and without MS according to NCEP-ATPⅢ diagnostic criteria. Severity of cerebrovascular were evaluated by CT. ResultsTwo hundred ninty cases(49.6%) complicated with MS showed higher body mass index (BMI), waist circumference, blood pressure, serum total cholesterol(TC), triglyceride (TG), uric acid (UA), fasting blood glucose (FBG), two hours postprandial blood glucose (2 h PBG), glucosylated hemoglobin A1c(HbA1c), and lower high-densitylipoprotein-cholesterol(HDL-C) than those without MS. Larger size and multiple infarcts and more serious score of neurological deficit were shown in patients complicated with MS. Severity of cerebrovascular disease disclosed by CT was positively related to levels of waist circumferene, blood pressure, TC, TG, HbA1c, FBG and 2 h PBG while in versely related to the levels of HDL-C (r=-1.23, P
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Stenting is one of the effective approaches in the treatment of cerebrovascular stenosis. It may reduce the risk of ischemic stroke in patients with symptomatic and asymptomatic cerebrovascular stenosis. With the increasing number of stenting procedures in the treatment of cerebrovascular stenosis, various complications have received attention. This article reviews some common complications and their management.