RÉSUMÉ
Objective To discuss the curative effect of unremitting pump infusion of microdose urokinase(100 000 u/24 h)into the cerebral venous sinus in treating thrombosis in cerebral venous sinus which had anatomical variation. Methods Mechanical disruption of the thrombus and unremitting pump infusion of microdose urokinase(100 000 u/24 h)into the cerebral venous sinus for 48-96 hours were employed in 9 patients with thrombosis in anatomically varied cerebral venous sinus.After the procedure the original disorder was actively treated and the anticoagulant therapy was continued for 6 months.A follow-up of 6-12 months(mean 10 months) was conducted. Results Recanalization of the previously occluded cerebral venous sinus was obtained in all 9 patients.The dose of urokinase was 100 000 u/24 h in 8 patients.For the remaining one patient the dose of urokinase was 100 000 u/24 h in the first 48 hours,then the dose Was increased to 250 000u/24 h. Excellent result was obtained in all patients.Conclusion Unremitting pump infusion of microdose urokinase into the cerebral venous sinus can effectively treat the thrombosis in anatomically varied cerebral venous sinus.
RÉSUMÉ
Objective To evaluate the changes of cerebral perfusion and hemodynamics in the patients with mono-carotid artery stenosis after stenting with the technique of DSA parametric imaging. Methods 15 patients with mono-carotid artery stenosis(the stenosis>75%) undergone carotid stenting were choosed. Digital subtraction imagines of diplo-carotid arteries were acquired before and after operation, then the imagines were processed by special soft ware in personal computer. The region of interest (ROI)were selected in the brain,internal carotid artery and superior sagittal sinus separately, the time-gray scale curves of the ROIs were drawn with the soft ware, from which,then acquired the following parameters from the time-gray scale curves,the largest gray values of brain in disordered side pre-and post-operation, and the parameters including peak value (PV), mean transit time (MTT) ,time to peak (TP), time of appearance to the peak , the max slope rate of the curve and relative time of cerebral circulation were also evalua-ted, respectively. The imaging speed was 7.5 pictures per second. The results were statistically evaluated by using matched-t test. Results Before the stenting, the values of the parameters peak value, the max slope rate of the curve,TP,MTT,relative time of cer-ebral circulation were 108.20±5.58 , 1.23±0.37 , (4.78±0.24)s , (8.20±0.42)s and(4.92±1.03)s , respectively; after the stenting , the values of the parameters above-mentioned were 114.20±7.58, 2.01±0.36, (4.14±0.40)s, (3.55±0.56)sand(4.18±0.89) s , respectively, the difference of the parame-ters above-mentioned pre-and post-operation were statisti-cally significant (t=5.97 , 8.00 , 0.21 , 10.21 , 10.12 and 4.14,P<0.05). Before and after operation, the values of time of appearance to the peak were (5.39±0.24) s and)(5.37±0.78) s , respectively , there was no statistical significance (t=0.21, P> 0.05). Conclusion DSA parametric imaging can be used to evaluate the changes of cerebral perfusion and hemodynamics before and after arterial stenting.