Treatment of patients older than 60 years with symptomatic vertebrobasilar artery stenosis / 中华医学杂志(英文版)
Chinese Medical Journal
; (24): 1068-1071, 2008.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-258554
Biblioteca responsable:
WPRO
ABSTRACT
<p><b>BACKGROUND</b>Vertebrobasilar artery stenosis is an important cause of ischemic posterior circulation strokes. This study aimed at evaluating the safety and efficacy of treatment including conservative therapy alone and conservative plus endovascular therapy for elderly patients with symptomatic vertebrobasilar artery stenosis.</p><p><b>METHODS</b>Patients older than 60 years with symptomatic vertebrobasilar artery stenosis (> or = 50%) confirmed by cerebral angiography were enrolled. All of them were treated with medical therapy and some with additional stent-assisted angioplasty (the stenting subgroup). Their clinical, imaging, intervention and follow-up data were analyzed.</p><p><b>RESULTS</b>One hundred and seventeen consecutive elderly patients (100 men, mean age (68.1 +/- 5.1) years) were enrolled and followed up for a mean time of 28.4 months; 81.7% of them were symptomatically resolved or improved; a stroke rate of 5.1% and a stroke-related death rate of 1.7% were found among them during the hospitalization and follow-up. In the stenting subgroup, 78 balloon expandable stents were employed in the 70 patients with a technical success rate of 98.7% and the mean degree of stenosis was significantly reduced from (81.7 +/- 14.3)% before stenting to (8.3 +/- 4.2)% after stenting (P < 0.001). Four (5.7%) periprocedural strokes occurred, of whom two led to death within 30 days after the procedure. During the follow-up (mean 27.7 months), sixty of the surviving 68 patients in the stenting subgroup were symptomatically resolved or improved. Only one (1.5%) posterior circulation stroke occurred, while duplex ultrasound scan of 34 patients demonstrated 10 (29.4%) in-stent restenosis.</p><p><b>CONCLUSIONS</b>Appropriate utilization of conservative therapy alone and conservative plus endovascular therapy may improve short-term clinical outcomes for elderly patients with symptomatic vertebrobasilar artery stenosis. Furthermore, stent-assisted angioplasty is technically feasible and relatively safe in elderly patients.</p>
Texto completo:
Disponible
Contexto en salud:
ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
Problema de salud:
Enfermedad Cardiovascular
/
Enfermedad Cerebrovascular
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Terapéutica
/
Insuficiencia Vertebrobasilar
/
Stents
/
Estudios Prospectivos
/
Estudios de Seguimiento
/
Resultado del Tratamiento
/
Angioplastia de Balón
/
Métodos
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Anciano
/
Anciano de 80 o más años
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Chinese Medical Journal
Año:
2008
Tipo del documento:
Artículo