Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomati...Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography(DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease(WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from(77.45 ± 8.44)% to(24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case(5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months(time range: 5–38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions(40.0%) underwent DSA follow-up examinations and 12 lesions(60.0%) were checked by CT angiography during the follow-up period. 3 lesions(15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.展开更多
Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the...Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the relationship between serum bilirubin levels and different degrees of atherosclerotic stenosis in intracranial or extracranial arteries. Methods: The study included 189 patients undergoing digital subtraction angiography (DSA) diagnosed as being normal or having been confirmed as atherosc lerotic stenosis in the intracranial or extracranial arteries. The patients were allocated to normal, mild (Results: Indirect bilirubin (Ibil) concentrations increased in parallel with the increasing severity of atherosclerotic stenosis in the intracranial or extracranial arteries, but decreased in patients with occluded cranial vessels. Multivariate analysis showed that Ibil levels were significantly higher in patients with severe stenosis group than in those with mild stenosis (OR, 1.464;95% CI, 1.050 - 2.042;P = 0.024). However, Ibil levels were significantly lower in patients with occlusion than in those with severe stenosis (OR, 0.790;95% CI, 0.684 - 0.913;P = 0.001). Conclusions: Ibil appears to have a protective effect against the development of atherosclerotic stenosis in intracranial or extracranial arteries. The biosynthesis of Ibil increases with stenosis progresses but decreases once occlusion occurs.展开更多
Intracranial artery stenosis(ICAS)in youth is an under-explored condition.ICAS is one of the leading causes of stroke in young people worldwide and confers a higher risk of stroke recurrence,leading to a poor prognosi...Intracranial artery stenosis(ICAS)in youth is an under-explored condition.ICAS is one of the leading causes of stroke in young people worldwide and confers a higher risk of stroke recurrence,leading to a poor prognosis for individuals and a great burden to society.The etiology and risk factors of ICAS in youth differ from those of older patients,thus resulting in a difference in the progression and prognosis of the disease.Even though the diagnosis of ICAS is lumen-based,it is sometimes difficult to identify in young patients based on imaging alone.Notably,novel vessel wall imaging techniques play an important role in determining the cause of stenosis and screening patients at high risk of recurrence.Moreover,pharmacologic regimens and risk factor control goals for ICAS in young adults are largely consistent with those in older patients.Thus,considering the poor prognosis,there is an urgent need for high-quality studies in the young ICAS population to analyze the high-quality observational data collected.展开更多
Background:Previous studies have shown that inflammation plays an important role in intracranial atherosclerotic stenosis(ICAS).The platelet-to-lymphocyte ratio(PLR)has recently emerged as a potential inflammatory bio...Background:Previous studies have shown that inflammation plays an important role in intracranial atherosclerotic stenosis(ICAS).The platelet-to-lymphocyte ratio(PLR)has recently emerged as a potential inflammatory biomarker.This study aimed to explore the association of the PLR with ICAS in a Chinese Han population.Methods:A total of 2134 participants(518 with ICAS,1616 without ICAS)were enrolled in this study.ICAS was defined as atherosclerotic stenosis>50%or the occlusion of several main intracranial arteries.Multivariable logistic regression analyses were used to assess the association of the PLR with ICAS.Additional subgroup analyses were performed according to age(<60 vs.≥60 years)and acute ischemic stroke.Results:Multivariate regression analysis showed that a high PLR was associated with a higher risk of ICAS in all participants(P<0.001).Compared with the lowest quartile,the fourth PLR quartile was significantly associated with ICAS(OR 1.705,95%confidence interval 1.278–2.275,P<0.001).In the subgroups stratified by age,an association between the PLR and ICAS was found in the late-life group(P<0.001),but not in the mid-life group(P=0.650).In the subgroups stratified by acute ischemic stroke,the relationship between an elevated PLR and a higher risk of ICAS remained unchanged(stroke group,P<0.001;non-stroke group,P=0.027).Conclusions:An elevated PLR was associated with a higher risk of ICAS in a Chinese Han population.The PLR might serve as a potential biomarker for ICAS in the elderly population.展开更多
文摘Purpose: To evaluate the safety and efficacy of Enterprise stent in the treatment of symptomatic complex intracranial atherosclerotic stenosis. Methods and materials: 20 complex cases among 53 patients with symptomatic ischemic stroke who were treated with balloon angioplasty and enterprise stents in Department of Neuro-interventional Radiology, The First Affiliated Hospital of Zhengzhou University from Jan. 2014 to Dec. 2017 were retrospectively enrolled in this study. Diagnostic criteria for complex intracranial atherosclerotic stenosis were as follows: 1) intracranial atherosclerotic stenosis was ≥70% confirmed by digital subtraction angiography(DSA) using the formulas described by the Warfarin Aspirin Symptomatic Intracranial Disease(WASID) method; 2) length of lesion was >10 mm. Basic characteristics of target lesions, technical success rate, perioperative safety, follow-up outcomes were investigated. Results: 20 patients were enrolled in this study, including 15 males and 5 females from 44 to 70 years old with an average age of 57.20 ± 9.25. 20 lesions were treated with 20 enterprise stents. The average preoperative and postoperative residual stenosis was reduced from(77.45 ± 8.44)% to(24.89 ± 16.61)%. The successful rate of operation was 100%. Among the perioperative complications, only 1 case(5%) experienced perforating branch event. The average clinical follow-up period was 13.15 ± 11.33 months(time range: 5–38). There were no ischemic events, no bleeding events and no various causes of death during the follow-up period. 8 lesions(40.0%) underwent DSA follow-up examinations and 12 lesions(60.0%) were checked by CT angiography during the follow-up period. 3 lesions(15.0%) developed ISR without any cerebral ischemia symptoms. Conclusion: This retrospective, single-center study suggests that enterprise stent is effective in the treatment of symptomatic complex intracranial atherosclerotic stenosis with less perioperative complications. Prospective, multicenter, randomized controlled trials are expected.
文摘Background: Bilirubin is the metabolic end-product of heme degradation by heme oxy-genase (HO), which has recently been shown to act as an antioxidant which can protect against atherosclerosis. This study explored the relationship between serum bilirubin levels and different degrees of atherosclerotic stenosis in intracranial or extracranial arteries. Methods: The study included 189 patients undergoing digital subtraction angiography (DSA) diagnosed as being normal or having been confirmed as atherosc lerotic stenosis in the intracranial or extracranial arteries. The patients were allocated to normal, mild (Results: Indirect bilirubin (Ibil) concentrations increased in parallel with the increasing severity of atherosclerotic stenosis in the intracranial or extracranial arteries, but decreased in patients with occluded cranial vessels. Multivariate analysis showed that Ibil levels were significantly higher in patients with severe stenosis group than in those with mild stenosis (OR, 1.464;95% CI, 1.050 - 2.042;P = 0.024). However, Ibil levels were significantly lower in patients with occlusion than in those with severe stenosis (OR, 0.790;95% CI, 0.684 - 0.913;P = 0.001). Conclusions: Ibil appears to have a protective effect against the development of atherosclerotic stenosis in intracranial or extracranial arteries. The biosynthesis of Ibil increases with stenosis progresses but decreases once occlusion occurs.
基金supported by the National Natural Science Foundation of China(82071468,82271507).
文摘Intracranial artery stenosis(ICAS)in youth is an under-explored condition.ICAS is one of the leading causes of stroke in young people worldwide and confers a higher risk of stroke recurrence,leading to a poor prognosis for individuals and a great burden to society.The etiology and risk factors of ICAS in youth differ from those of older patients,thus resulting in a difference in the progression and prognosis of the disease.Even though the diagnosis of ICAS is lumen-based,it is sometimes difficult to identify in young patients based on imaging alone.Notably,novel vessel wall imaging techniques play an important role in determining the cause of stenosis and screening patients at high risk of recurrence.Moreover,pharmacologic regimens and risk factor control goals for ICAS in young adults are largely consistent with those in older patients.Thus,considering the poor prognosis,there is an urgent need for high-quality studies in the young ICAS population to analyze the high-quality observational data collected.
基金This study was supported by grants from the Taishan Scholars Program of Shandong,Province,(Nos.ts201511109 and tsqn20161079)the Qingdao Key Health Discipline Development Fund.
文摘Background:Previous studies have shown that inflammation plays an important role in intracranial atherosclerotic stenosis(ICAS).The platelet-to-lymphocyte ratio(PLR)has recently emerged as a potential inflammatory biomarker.This study aimed to explore the association of the PLR with ICAS in a Chinese Han population.Methods:A total of 2134 participants(518 with ICAS,1616 without ICAS)were enrolled in this study.ICAS was defined as atherosclerotic stenosis>50%or the occlusion of several main intracranial arteries.Multivariable logistic regression analyses were used to assess the association of the PLR with ICAS.Additional subgroup analyses were performed according to age(<60 vs.≥60 years)and acute ischemic stroke.Results:Multivariate regression analysis showed that a high PLR was associated with a higher risk of ICAS in all participants(P<0.001).Compared with the lowest quartile,the fourth PLR quartile was significantly associated with ICAS(OR 1.705,95%confidence interval 1.278–2.275,P<0.001).In the subgroups stratified by age,an association between the PLR and ICAS was found in the late-life group(P<0.001),but not in the mid-life group(P=0.650).In the subgroups stratified by acute ischemic stroke,the relationship between an elevated PLR and a higher risk of ICAS remained unchanged(stroke group,P<0.001;non-stroke group,P=0.027).Conclusions:An elevated PLR was associated with a higher risk of ICAS in a Chinese Han population.The PLR might serve as a potential biomarker for ICAS in the elderly population.
