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Objective To evaluate the safety and efficacy of early carotid artery stenting in treating cerebral watershed infarction patients with carotid artery stenosis. Methods A total of 33 patients with acute cerebral watershed infarction complicated by carotid artery stenosis received carotid artery stenting within one week after the onset of the disease. The clinical safety and efficacy were evaluated. Results The carotid artery stenting was successfully accomplished in all 33 patients with a success rate of 100%. After the procedure, different degree of bradycardia and hypotension was seen in 23 patients, which restored to normal after prompt medication with atropine, dopamine, etc. During the procedure, one patients developed cerebral embolism due to dislodgment of emboli, resulting in contralateral hemiparalysis, and the contralateral limb muscle strength returned to preoperative status after proper treatment. After the treatment, no ipsilateral hemisphere excessive perfusion or cerebral hemorrhage occurred. Thirty days after the treatment, NHISS scores of the patients were obviously improved, which were significantly different from those determined before the treatment (P<0.05). Conclusion For the treatment of acute cerebral watershed infarction, early carotid artery stenting to relieve carotid artery stenosis is quite safe and it may improve the prognosis as well.
RESUMO
Objective To investigate the effect of butylphthalide on cerebrovascular reactivity (CVR) in patients with severe intracranial internal carotid stenosis.Methods The patients with severe intracranial internal carotid stenosis diagnosed by cerebral angiography in Nanjing Stroke Registry Program from January 2010 to November 2010 were randomly divided into either the butylphthalide group or the control group.All patients received the oral drugs for ischemic cerebrovascular disease that met the guideline criteria,and butylphthalide 20 mg,3 times a day orally was added in the butylphthalide group.The CVR was evaluated by transcranial Doppler and CO2 inhalation challenge test,and reexamined 3 months after treatment.Results A total of 81 patients met the inclusion criteria,11 (13.6％) were lost to follow-up,and finally 70 (n =35 in each group) were included in the analysis.The mean age of the patients was 55.2 ± 9.0 years,47 of them were male and 23 were female.The degree of vascular stenosis was 72％ to 99％ (mean 79.4％ ± 9.5％).The CVR was improved significantly after 3 months of treatment in the butylphthalide group than that in the control group (P =0.007),but it was not improvedsignificantly in the control group (P =0.330).All the patients did not have ischemic stroke events during the medication.No serious adverse reactions occurred in the butylphthalide group.Conclusions Butylphthalide may improve the CVR in patients with severe intracranial internal carotid stenosis.