RÉSUMÉ
Objective To explore the changes and influencing factors of cerebral vasoreactivity (CVR) in patients after carotid angioplasty and stenting (CAS). Methods Thirty-seven patients performed CAS, admitted to our hospital from July 2008 to September 2009, were finished the follow-up and chosen in our study; the breath-holding index (BHI) of the bilateral middle cerebral artery was measured using transcranial Doppler combined with breath holding test before thc operation, and 1 d and 3-10 months after the operation. Repeated measures design analysis of variance was employed to detect the BHI changes before and after the stenting; multiple regression was employed to analyze the influencing factors of BHI. Results BHI values after stenting were significantly higher than those before stenting on the stenotic side (P＜0.05). The follow-up BHI values were negatively correlated with those of tandem stenoses (β=-0.016, P=0.002) and positively correlated with the postoperative BHI values (β=1.030, P=0.000). Conclusion CAS can immediately improve CVR on the ipsilateral side and make it close to normalization gradually. Tandem stenoses are the independent risk factors of CVR.
RÉSUMÉ
Objective To investigate the clinical and neuroimaging features of cerebral microbleeds(CMBs)in patients with ischemic stroke. Methods MRI,including gradient-echo T2~*-weighted MRI,was performed in 85 patients with acute ischemic stroke.Their clinical information and imaging characteristics were analyzed. Results One hundred and twenty-four CMBs were noted in 26 patients(30.6%)with the number of CMBs ranged from 1 to 16 per patient.CMBs were more frequently presentcd in the cortical-subcortical region and thalamus-basal ganglia than in the cerebellum and brain stem legions.Some CMBs in the brain stem had related neurological symptoms and signs.CMBs,the age of the patient,the number of lacunar infarcts and the white matter changes were correlative(r=0.243,P=0.025;r=0.337,P=0.025;r=0.438,P=0.000).CMBs could be well demonstrated in the gradient-echo T2~*-weighted MRI and some larger ones could be demonstrated in the apin-echo T2~*-weighted MRI and DWI. Conclusion CMBs are the sighs for microangiopathy in the brain with advanced age,mutiple lacunar infartion and leukoaraiosis as its main prognosis factors.
RÉSUMÉ
Objective To investigate the effect of prophylactic administration of atropine before carotid angioplasty and stenting (CAS) on the happening of intraoperative and postoperative hypotension,bradycardia or cardiovascular complications. Methods Seventy-seven patients with carotid atherosclerosis, admitted to our hospital from November 2008 to May 2010 and performed CAS, were chosen in the study. Prophylactic administration of atropine before CAS was performed on 42 patients and the other 35 without atropine administration were adopted as control group. The clinical data of these patients were analyzed and the high risk factors of cardiovascular events (hypotension or bradycardia) at the perioperative period were observed. The incidence of cardiovascular complications at the perioperative period was also recorded and compared. Results No significant differences on the clinical data, high risk factors of cardiovascular events and morphological characteristics of the vessels were noted between the 2 groups (P＞0.05). The operation procedures were almost the same between the 2 groups. As compared with the control group, the atropine treatment group enjoyed significantly lower incidences of intraoperative or perioperative bradycardia and cardiovascular complications at the perioperative period (P＜0.05). Conclusion The prophylactic administration of atropine before CAS decreases the incidence ofbradycardia and cardiovascular complications during and after CAS.