Clinical Effect of Surgical Reconstruction of Extracranial Vertebral Artery / 中国医学科学院学报

Objective To evaluate the effect of surgical reconstruction of extracranial vertebral artery and to summarize the experience. Methods The clinical data of 15 patients undergoing surgical reconstruction of extracranial vertebral artery from September 2018 to June 2022 were collected.The operation methods,operation duration,intraoperative blood loss,operation complications,and relief of symptoms were retrospectively analyzed. Results Eleven patients underwent vertebral artery (V1 segment) to common carotid artery transposition,two patients underwent endarterectomy of V1 segment,two patients underwent V3 segment to external carotid artery bypass or transposition.The operation duration,intraoperative blood loss,and blocking time of common carotid artery varied within 120-340 min,50-300 ml,and 12-25 min,with the medians of 240 min,100 ml,and 16 min,respectively.There was no cardiac accident,cerebral hyperperfusion syndrome,cerebral hemorrhage or lymphatic leakage during the perioperative period.One patient suffered from cerebral infarction and three patients suffered from incomplete Horner's syndrome after the operation.During the follow-up (4-45 months,median of 26 months),there was no anastomotic stenosis,new cerebral infarction or cerebral ischemia. Conclusion Surgical reconstruction of extracranial vertebral artery is safe and effective,and individualized reconstruction strategy should be adopted according to different conditions.

Carotid endarterectomy combined with vertebral artery transposition treating vertebral artery V1 segment stenosis combined with ipsilateral carotid artery stenosis / 中国胸心血管外科临床杂志

@#Objective    To explore the treatment outcome of carotid endarterectomy combined with vertebral artery transposition in patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery. Methods    From June 2017 to September 2020, patients with severe stenosis to occlusion of the vertebral artery V1 segment and the ipsilateral carotid artery treated with carotid endarterectomy combined with vertebral artery transposition in Fuwai Hospital were retrospectively analyzed. Results    Finally 12 patients were enrolled, including 10 males and 2 females with an average age of 67.8±6.0 years. Twelve patients were successfully operated and the follow-up time was 1-3 years. The stenosis degree of the V1 segment of the vertebral artery decreased from 83.5%±11.8% to 24.9%±14.3% (P<0.001). The stenosis degree of carotid artery decreased from 85.6%±11.0% to 0% (P<0.001). Postoperative follow-up showed that the symptoms of symptomatic patients before surgery improved. The 1-year and 3-year patency rates were 100.0%, and there were no peripheral nerve injury complications, perioperative deaths or strokes. Conclusion    Carotid endarterectomy combined with vertebral artery transposition can treat ipsilateral carotid artery  stenosis and vertebral artery stenosis at the same time, improve blood supply to the brain, improve patients' symptoms and has high promotion value.

Modified vertebral-carotid transposition treating stenosis at V1 segment of vertebral artery / 中国胸心血管外科临床杂志

@#Objective    To investigate the treatment of modified vertebral-carotid transposition (VCT) in patients with severe stenosis or occlusion at V1 segment of vertebral artery. Methods    A retrospective study of 13 patients with severe stenosis or occlusion at V1 segment of vertebral artery treated by modified VCT in our hospital from October 2016 to December 2018 was done. There were 10 males and 3 females with an average age of 70.5±7.1 years. Results    The operation was successful in this series of patients. The follow-up duration was 1-3 years. The stenosis degree of the V1 segment of the vertebral artery decreased from 86.8%±7.5% to 17.4%±14.5%. All patients achieved remission of symptoms after the surgery. Temporary peripheral nerve injury occurred in 6 patients. Four patients with neurological complications relieved during follow-up. The patency rate was 100.0% at postoperative 1 and 3 years. There was no perioperative death, stroke or re-intervention. Conclusion    Modified VCT can precisely restore the distal blood flow of patients with severe stenosis or occlusion at V1 segment of vertebral artery, and relieve their symptoms.

Correlation between the hemodynamic parameters of extracranial vertebral artery and the severity and location of intracranial vertebral artery stenosis / 中华超声影像学杂志

Objective To analyze the effects of the degree and location of intracranial vertebral artery (VA) lesions on the hemodynamic parameters of extracranial VA.Methods A total of 275 consecutive patients who were diagnosed as posterior circulation ischemic stroke or transient ischemic attack (TIA) with unilateral intracranial VA stenosis or occlusion in the Department of Neurology and Neurosurgery of Capital Medical University Xuanwu Hospital from January 2015 to December 2017 were enrolled.All patients were examined by head and neck vascular ultrasound,CT angiography (CTA) and/or digital subtraction angiography (DSA) within one week.According to the results of DSA or CTA,the patients were divided into mild stenosis group (53 patients),moderate stenosis group (62 patients),severe stenosis group (58patients) and occlusion group(102 patients).The inner diameter (D),peak systolic velocity (PSV),end diastolic velocity (EDV),and resistance index (RI) of the extracranial segment (V2 segment) of the VA were recorded and analyzed.Results The PSV and EDV in the severe stenosis group and the occlusion group were significantly lower than those in the mild stenosis group and the moderate stenosis group (P =0.000),and the PSV and EDV in the occlusion group were significantly lower than those in the severe stenosis group[(31 ± 10) cm/s vs (46 ± 12)cm/s,(5 ± 4)cm/s vs (15 ± 7)cm/s;all P =0.000],RI was significantly higher than the other three groups (0.85 ± 0.12,0.70 ± 0.10,0.66 ± 0.07,0.64 ± 0.06,respectively;all P =0.000);RI in the severe stenosis group were not significantly different from those in the mild to moderate stenosis groups (P =0.044,0.223).There were no significant differences in the inner diameter,PSV,EDV and RI between the subgroups in the severe stenosis group before or after the PICA (posterior inferior cerebellar artery) (P =0.130,0.322,0.865,0.227).However,the EDV decreased and RI increased in the occlusive subgroup before the PICA when compared the subgroup after the PICA (all P =0.000).Conclusions The location and degree of intracranial VA lesions directly affect the changes of blood flow velocity and vascular resistance of extracranial VA,and the changes of low-speed and high-resistance hemodynamics of extracranial VA may indicate the existence of occlusive lesions in intracranial VA.

Endovascular treatment of symptomatic severe vertebral artery stenosis / 中国医师杂志

About 25％-40％ of ischemic stroke is in the posterior circulation,in which 20％ of posterior circulation stroke is caused by vertebral artery stenosis.Patients with symptomatic vertebral artery stenosis have a high risk of recurrent stroke.At present,the treatments of vertebral artery stenosis include medication,open surgery and interventional therapy.In this paper,the endovascular treatment of vertebral artery stenosis is reviewed,especially the progress of endovascular treatment is expounded,in order to promote the development of its treatment.

Correlation between the hemodynamic parameters of extracranial vertebral artery and the severity and location of intracranial vertebral artery stenosis / 中华超声影像学杂志

Objective@#To analyze the effects of the degree and location of intracranial vertebral artery(VA) lesions on the hemodynamic parameters of extracranial VA.@*Methods@#A total of 275 consecutive patients who were diagnosed as posterior circulation ischemic stroke or transient ischemic attack (TIA) with unilateral intracranial VA stenosis or occlusion in the Department of Neurology and Neurosurgery of Capital Medical University Xuanwu Hospital from January 2015 to December 2017 were enrolled. All patients were examined by head and neck vascular ultrasound, CT angiography (CTA) and/or digital subtraction angiography (DSA) within one week. According to the results of DSA or CTA, the patients were divided into mild stenosis group(53 patients), moderate stenosis group(62 patients), severe stenosis group(58 patients) and occlusion group(102 patients). The inner diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV), and resistance index (RI) of the extracranial segment (V2 segment) of the VA were recorded and analyzed.@*Results@#The PSV and EDV in the severe stenosis group and the occlusion group were significantly lower than those in the mild stenosis group and the moderate stenosis group (P=0.000), and the PSV and EDV in the occlusion group were significantly lower than those in the severe stenosis group[ (31±10) cm/s vs (46±12)cm/s, (5±4)cm/s vs (15±7)cm/s; all P=0.000], RI was significantly higher than the other three groups (0.85±0.12, 0.70±0.10, 0.66±0.07, 0.64±0.06, respectively; all P=0.000); RI in the severe stenosis group were not significantly different from those in the mild to moderate stenosis groups (P=0.044, 0.223). There were no significant differences in the inner diameter, PSV, EDV and RI between the subgroups in the severe stenosis group before or after the PICA (posterior inferior cerebellar artery)(P=0.130, 0.322, 0.865, 0.227). However, the EDV decreased and RI increased in the occlusive subgroup before the PICA when compared the subgroup after the PICA (all P=0.000).@*Conclusions@#The location and degree of intracranial VA lesions directly affect the changes of blood flow velocity and vascular resistance of extracranial VA, and the changes of low-speed and high-resistance hemodynamics of extracranial VA may indicate the existence of occlusive lesions in intracranial VA.

Endovascular treatment of symptomatic severe vertebral artery stenosis / 中国医师杂志

About 25%-40% of ischemic stroke is in the posterior circulation, in which 20% of posterior circulation stroke is caused by vertebral artery stenosis. Patients with symptomatic vertebral artery stenosis have a high risk of recurrent stroke. At present, the treatments of vertebral artery stenosis include medication, open surgery and interventional therapy. In this paper, the endovascular treatment of vertebral artery stenosis is reviewed, especially the progress of endovascular treatment is expounded, in order to promote the development of its treatment.

Effects of endovascular stent implantation and medical treatment on symptomatic vertebral artery stenosis / 中国综合临床

Objective To investigate the clinical effect of endovascular stent implantation and medical treatment in the treatment of symptomatic vertebral artery stenosis. Methods Eighty patients with symptomatic vertebral artery stenosis admitted from January 2013 to May 2015 in the Department of Neurology of Wuhan Puren Hospital were selected. The patients were randomly divided into the observation group and the control group,with 40 cases in each group. The control group was given aspirin enteric?coated tablets 100 mg/ time,1 time /d,clopidogrel bisulfate bablets 75 mg/ time,1 time /d,atorvastatin calcium 10 mg/ time,1 time/d. The observation group was treated with intravascular stent implantation. After 1 years of follow?up, the degree of vascular stenosis,the occurrence of ischemic cerebrovascular time and the clinical effect of the two groups were compared. Results (1) The stenosis degree of the observation group and the control group before treatment was (72. 81±11. 99)％ and (68. 31±12. 35)％ respectively,after treatment,it was (24. 58±1. 24)％ and (56. 01 ±3. 30)％ respectively. There was no significant difference between the two groups before treatment (t=0. 121,P>0. 05). After treatment,vascular stenosis degree in two groups were significantly improved,compared with that before treatment,the differences were statistically significant (t=0. 790,P<0. 05; t=0. 457,P<0. 05); the degree of vascular stenosis after treatment in the observation group was significantly lower than that in the control group ( t=0. 842,P<0. 05);( 2) during follow?up,the total occurrence rate of ischemic cerebrovascular events in the observation group was 17. 5％ (7/40),compared to 37. 5％ (15/40) in the control group,the difference between the two groups was statistically significant (χ2=4. 065,P<0. 05) . ( 3) At 1 years of follow?up,the total effective rate of the observation group was 97. 5％ ( 39/40) ,while that of the control group was 60％ ( 24/40) , and the difference between the two groups was statistically significant ( P=0. 017) . Conclusion Endovascular stent implantation can effectively improve the clinical efficacy of symptomatic vertebral artery, reduce the incidence of ischemic cerebrovascular time,and improve the degree of vascular stenosis.

To analyse the rate of intraplaque hemorrhage in symptomatic vertebral artery stenosis by high-resolution MRI / 实用医学杂志

Objective To compare the rate of intraplaque hemorrhage between symptomatic and asymptom-atic vertebral artery stenosis groups using high-resolution magnetic resonance imaging(HR-MRI).Methods The patients diagnosed with PCI and with vertebral artery stenosis using HR-MRI were enrolled retrospectively. They were divided into symptomatic and asymptomatic groups according to whether they were detected with PCI by the re-sponsible vertebral artery stenosis before examination. All patients underwent 3D time of flight magnetic resonance angiography(3D TOF MRA)to detect the stenosis location of vertebral artery and the stenosis rate at the narrow-est. T1-weighted fat-suppressed images were positioned on the atherosclerotic plaque that the signal 150% higher than the surrounding muscle was confirmed to be intraplaque hemorrhage. Statistical significance was assessed by chi-square test or Student′s unpaired t test.Results A total of 60 patients were included in this study,28 patients in the symptomatic group and 32 patients in the asymptomatic group.The rate of vertebral artery stenosis in asymp-tomatic group was higher than symptomatic group,but there was no statistical significance[(72 ± 33)% vs.(65 ± 28)%,P=0.383];the number of intraplaque hemorrhage in symptomatic group was significantly higher than that in the asymptomatic group(9 vs.2,P=0.024).Conclusions There is a higher rate of intraplaque hemorrhage in symptomatic vertebral artery stenosis group than asymptomatic group.Intraplaque Hemorrhage could be one of risk factor of acute ischemic cerebral disease.

Role of ultrasonography in diagnosis of vertebral artery stenosis / 中国基层医药

Objective To discuss the function and advantages of ultrasound technology in various factors in the diagnosis of vertebral artery stenosis lesions.Methods The objective data of ultrasonography were selected in 60 patients (120 vertebral arteries) with paroxysmal,reversible vertigo and headache as the chief complaint,the internal relations were summarized and analyzed.Results In the subjects of study,the vertebral artery stenosis for 38.2％,vertebral artery course tortuosity changer accounted for 33.3％,congenital abnormal development accounted for 9.8％,mixed cause 18.6％,dominant etiology was vertebral artery sclerosis and vertebral artery tortuosity change.Conclusion Ultrasound technology has important value of clinical application in the reasons diagnosis of vertebral artery stenosis disease,it can help extend clinical diagnosis.

Efficacy analysis of stent angioplasty on symptomatic stenoses of vertebral arteries origins / 中国基层医药

Objective To evaluate the safety and efficiency of endovascular stenting on symptomatic stenosis of vertebral artery origin .Methods 62 patients with symptomatic stenosis of vertebral artery origin received vertebral stenting.Before and after operation ,vascular stenosis rate and clinical symptoms were observed ,and follow-up on all cases.Results The stents was successfully performed in 62 patients.The symptomatic stenosis and clinical symptoms were significantly improved.The stenosis rate decreased from (77.4 ±15.3)%to (12.2 ±6.5)%.The postoperative follow-up lasted for 6-42months.5 cases developed restenosis .Conclusion Endovascular stenting for symptomatic stenosis of vertebral artery origin is safe and effective ,but the long-term curative effect of this technique should be further observed .

Risk factors analysis for restenosis after vertebral artery origin stenting / 中国脑血管病杂志

Objective To investigate the in-stent restenosis after vertebral artery ostium stenting (VAOS),and to determine the risk factors for in-stent restenosis. Methods Respective analysis of clinical data of 775 cases received VAOS in Xuan Wu Hospital of Capital Medical University from Jan. 2006 to Dec. 2012. Severe stenosis of vertebral artery ostium were diagnosed by DSA,and followed-up by ultrasound. The risk factors were assessed by COX analysis for in-stent restenosis ≥50%. Results This study included 775 patients. Surgical success rate was 99. 87%(n=774),technique success rate was 99. 48%(n=771 ). Two patients had cerebral hemorrhage after operation,one of them was dead. Four patients had cerebral infarction. The mean follow-up period was 12 months. The restenosis rate was 35. 89%(234/652 ). 79. 91% of restenosis occurred within 12 months after operation. COX analysis showed the vessels diameter after stenting was the independent predictors of in-stent restenosis (P<0. 01). The in-stent restenosis rate of drug-eluting stents was lower than metal-bare stents (HR 0. 532,95%CI 0. 397-0. 713,P<0. 01). Conclusion The in-stent restenosis was peculiarly prone to the smaller vessels diameter after VAOS. Drug-eluting stents were superior to metal-bare stents in preventing in-stent restenosis.

Evaluation criteria of transcranial color-coded sonography for the hemodynamics of intracranial segment vertebral artery stenosis / 中国脑血管病杂志

Objective To investigate the criteria of hemodynamic parameters for diagnosis of intracranial segment vertebral artery stenosis with transcranial color-coded sonography (TCCS ). Methods A total of 622 outpatients or inpatients with suspected posterior circulation ischemia were enrolled retrospectively,from which 216 patients were selected with TCCS,color Doppler flow imaging (CDFI)screen,and digital subtraction angiography (DSA)examination,including 33 patients (15. 3%) had normal intracranial vertebral arteries,the stenosis rates<50% were 45 cases (20. 8%),50%-69%were 44 cases (20. 4%),and 70%-99% were 94 cases (43. 5%). The mean velocity (MV)of intracranial segment,the ratios SPRP (PSV1/PSV2 ),SPRE (EDV1/EDV2 )of the systolic and end diastolic flow velocity between the intracranial segment and the intervertebral space segment were calculated respectively by detecting the intracranial segment of vertebral artery,the intervertebral space segment peak systolic velocity (PSV1 ,PSV2 )and end diastolic velocity (EDV2 ,EDV1 ). The DSA findings were used as the criteria,the area under the receiver operating characteristic (ROC ) curve was calculated and the optimal cut-off points were obtained. Results The optimal cut-off points of TCCS diagnosis of intracranial vertebral artery stenosis were as follows:the parameter standards of stenosis rate <50% were 110 cm/s≤PSV1≤145 cm/s and 65 cm/s≤MV≤85 cm/s,the parameter standards of stenosis rate 50%-69%were 145 cm/s≤PSV1≤190 cm/s and 85 cm/s≤MV≤115 cm/s,and the parameter standards of stenosis rate 70%-99% were PSV1≥190 cm/s and MV≥115 cm/s. Conclusion TCCS may effectively evaluate the hemodynamic changes of intracranial vertebral artery stenosis and provide reference for the ultrasound evaluation criteria of intracranial vertebral artery stenosis.

Diagnostic value of contrast-enhanced magnetic resonance angiography for vertebral artery ostial stenosis / 中国脑血管病杂志

Objective: To evaluate the value of contrast-enhanced magnetic resonance angiography (CE-MRA) in the diagnosis of vertebral stenosis. Methods: A total of 108 patients (216 vertebral arteries) with clinical ischemic symptoms were examined by CE-MRA, then they were examined with digital subtraction angiography (DSA) within one week after CE-MRA examination. Using DSA as a standard, the accuracy of CE-MRA in the diagnosis of vertebral arteries was evaluated. Results: Circled digit oneOf the 216 vertebral arteries, 188 (87.0%) were consistent with the results of CE-MRA and DSA. The stenosis degree of 24 arteries (11.1%) determined by CE-MRA was higher than those determined by DSA. The stenosis degree of 4 arteries (1.9%) determined by CE-MRA was lower than those determined by DSA. Spearman rank correlation coefficient of the 2 kinds of examination was rs = 0.785 (P <0.001). Circled digit twoIn 168 normal vertebral arteries examined by CE-MRA, 2 were mild stenosis (stenosis rate ≤49%) and 2 were moderate to severe stenosis (stenosis rate 50-99%) examined by DSA. Of the 8 arteries with mild stenosis diagnosed by CE-MRA, DSA confirmed that 6 arteries were normal; of the 30 arteries with moderate to severe Stenosis diagnosed by CE-MRA, DSA confirmed that 10 were mild stenosis and 8 were normal. CE-MRA examination showed that the 10 occluded arteries were all confirmed by DSA. Circled digit threeUsing DSA as the gold standard, the sensitivity, specificity, false positive rate, false negative rate, positive predictive value, negative predictive value, and diagnostic consistent of CE-MRA rate were 89.5% (34/38), 92.1% (164/178), 7.9% (14/178), 10.5% (4/38), 70.8% (34/48), 97.6% (164/168), and 91.7% (198/216) , respectively. The Youden index was Y = 0.816. Conclusion: CE-MRA has high sensitivity in the diagnosis of vertebral artery ostial stenosis, it can be used as a screening means for detection. However, if we want to accurately evaluate the stenotic degree of vertebral artery, a variety of examination methods are needed.

Hemodynamics alteration after the vertebral artery stenting in patients with bilateral vertebral artery severe stenosis and its relationship with restenosis / 中国脑血管病杂志

Objective: To investigate the effect of contralateral vertebral arterial hemodynamics after unilateral vertebral artery stenting and its relationship with restenosis. Methods: A total of 155 patients with severe stenosis (70-99%) at the origin of unilateral vertebral artery confirmed by digital subtract angiography (DSA) and underwent stent implantation were recruited in the study. According to the contralateral vertebral artery lesions, they were divided into 3 groups: normal group (n = 71), severe stenosis group (n = 29 ) and occlusion group (n = 55). Carotid color Doppler flow imaging (CDFI) and transcranial Dopper (TCD) were performed before stenting, within 1 week, and 1 year after stenting. Peak systolic velocity (PSV) and end diastolic velocity (EDV) of vertebral arteries at the original part (OS), intervertebral segment(IV) and intracranial (IC) segments were recorded. Results: Circled digit oneCompared to the normal group within 1 week after stenting, the PSVOS and EDV OS of the original part of the stent side vertebral artery in the severe stenosis group increased slightly, but there were no significant differences; the PSVOS and EDVOS in the occlusion group increased significantly (P < 0.05). The PSV and EDV of the intervertebral and intracranial segments at the stent side in the severe stenosis group and the occlusion group were significantly higher than those in the normal group (P < 0.05). The above parameters on the stent sides in the occlusion group were slightly higher than those in the severe stenosis group, but the difference was not statistically significant. Circled digit twoOne year after stenting, 79 patients were followed up with ultrasound. There were 35 patients in the normal group, 15 in the severe stenosis group, and 29 in the occlusion group. The severe stenosis group and occlusion group were combined and analyzed (lesion group). PSVos and EDVos of stent side in the lesion group were significantly higher than those in the normal group; the restenosis rate of stent side in the normal group was 34.3% (12/35), while that in the lesion group was 56.8% (25/44). There were significant difference between the two groups (P < 0.05). Circled digit threeMultivariate logistic regression analysis showed that the severe lesion (severe stenosis or occlusion) of the contralateral vertebral artery was an independent risk factor for restenosis on the stent side (OR, 3.261, 95% CI: 1.174 to 9.058). Conclusion: When there is severe lesions at the original part of bilateral vertebral artery, the stent side of vertebral artery after stenting may immediately play a compensatory role for the blood flow on the non-stent side, however, this compensatory role is also one of the risk factors for occurring in-stent restenosis.

Observing the change of cerebral blood flow perfusion in acute vertebral artery stenosis in dogs by ~(99)Tc~m-ECD imaging / 中国临床药理学与治疗学

AIM: To observe the early changes of local cerebral blood supply in dogs during the acute vertebral artery stenosis by 99 TcmECD cerebral blood flow perfusion imaging(CBFPI).METHODS: Twenty-four dogs were randomized into groups of normal controls(A),moderate stenosis(B),severe stenosis(C) and arterial occlusion(D),with 6 in each group.Group A were free from any intervention,but Group B,C and D were undergone ligation of the right vertebral arteries by the extent of 50%～69%(Group B),70%～99%(Group C) or 100%(Group D).The imaging agents were injected intravenously 0.5-1 h after ligation and the single photon emission computed tomography(SPECT) was performed after 1 h.RESULTS: CBFPI examination of the early changes of cerebral blood supply during the acute vertebral artery stenosis by visualization showed that the sensitivity was 33.3%,83.3% and 100% in Group B,C and D,respectively,with an average sensitivity of 72.2%,while semi-quantitative assessment suggested that the sensitivity was 50%,100% and 100% in the three groups,respectively,with an average sensitivity of 83.3%.When examining the activity ratio for regions of interest(ROI) by semi-quantitative 99 Tcm-ECD CBFPI,the findings suggested that Group D and C decreased significantly(exception in cerebellum in Group C),but Group B had no evident changes,as compared with Group A.By comparison of the groups of B-C,B-D and C-D,differences were observed in the right temporal lobes,whereas the changes in left temporal lobes were seen in Group B-C or B-D.The changes were seen in occipital lobes when groups of B and D were compared,but with no differences in cerebellum.CONCLUSION: The degree of stenosis in vertebral arteries may involve varied regions,the temporal lobe is susceptive,followed by occipital lobe,while cerebellum is somewhat resistant from the involvement.

Two Cases of Spinal Cord Infarction: Vertebral Stenosis and Systemic Hypoperfusion

We experienced two cases of cord infarction. One patient developed quadriparesis and impaired pain and temperature sensation, whose T2-weighted MRI revealed a high-intensity lesion from medulla to C5. Angiography showed severe stenosis of both vertebral arteries. Another patient developed paraplegia and loss of all sensory modalities after cardiac arrest, whose T2-weighted MRI revealed a high-intensity lesion in the cord at T11-L1. We conclude that each cause of the infarctions was stenosis of the vertebral arteries and systemic hypoperfusion.

Clinical value of color doppler ultrasonography to extracranial vertebral artery stenosis before and after percutaneous transluminal angioplasty and stent treatment / 临床神经病学杂志

Objective To investigate the clinical value of color doppler ultrasonography(CDU) to extracranial vertebral artery stenosis before and after percutaneous transluminal angioplasty and stent(PTAS) treatment.Methods 61 patients with extracranial vertebral artery stenosis confirmed by digital subtraction angiography(DSA) were detected by CDU on both sides of extracranial vertebral artery before and 3 d,30 d after PTAS.The flow volume(FV),peak systolic velocity(PSV) and resistance index(RI) at the site of C5-C6 segment and stenosis were as analysis targets.Results Before PTAS,80 stenotic extracranial vertebral arteries were found by CDU(mild degree 17 cases,moderate degree 38 cases,severe degree 25 cases).Compared with DSA,coincidence was 86.9%(77.3%,95.0%,83.3%).Among them,the coincidence of moderate extracranial vertebral artery stenosis detected by CDU was excellent(P0.05).Conclusion CDU has the important value in diagnosing extracranial vertebral artery stenosis,and can be used to follow up the blood hemodynamics in the extracranial vertebral artery of patients treated by PTAS.It provided a method for observing the efficacy of PTAS treatment.