Surgical experience ofs et noses or occlusion of the vertebral artery / 中国医师杂志

Objective To explore surgical experience of stenoses or occlusion of the vertebral artery .Methods In this group, there were 28 patients including 21 men and 7 females with average of 52 ~73 (68.3 ±0.03) y, duration 3 months to 4 years , and 15 lesions in the left and 13 lesions in the right .All patients were performed operation under general anesthesia .There were 16 vertebral artery endarterectomy , 10 subclavian-vertebral bypass and 2 end-side anastomosis between vertebral artery and common ca-rotid artery.Results One patient had to be performed second operation at the 7th day after endarterectomy because of anastomotic bleeding.All patients were cured.The patency rate of 6 months was 89.28%(25/28) in all patients.Conclusions Surgical man-agement of stenoses or occlusion of the vertebral artery has excellent curative effect with simply operation .However , the technique must be selected according to anatomic circumstances of vertebral artery and subclavian artery .

The preliminary study on hemodynamics change of brain before and after vertebrobasilar angioplasty and stenting in the patients with intracal stenosis / 中国医师杂志

Objective To evaluate the hemodynamics change of brain before and after vertebrobasilar angioplasty and stenting in the patients with intracal stenosis.Methods All the indexes were compared among thirty-eight patients with intracal arterial stenosis,including mean peak flow velocity,systolic peak flow velocity,and resistance index of hemodynamics ; Cerebral blood volume ( CBV),cerebral blood flow (CBF)and middle time to peak(MTT) before and after the operation.Results After vertebro-basilar angioplasty and stenting in the 38 patients,the Vs of PCA were significantly lower in the affected side [ (226 ±27)cm/s vs (135 ± 18)cm/s; t =21.74,P ＜0.01 ].Significant difference was found between pro-and post stenting of rMTT and rCBF in the blood territories of stenotic cerebrovascular ( t =3.987,P =0.001 )and( t =-2.027,P =0.029),There was no significant difference between pro-and post stenting of rCBV in the blood territories of stenotic cerebrovascular ( t =-0.901,P =0.329).Conclusions Transcranial Doppler and CT perfusion can be used to evaluate hemodynamic changes before and after pereutaneous transluminal angioplasty and stenting.