Percutaneous angioplasty and stenting for the treatment of extracranial vertebral artery(VA) stenosis seems a safe,effective and useful technique for resolving symptoms and improving blood flow to the posterior circul...Percutaneous angioplasty and stenting for the treatment of extracranial vertebral artery(VA) stenosis seems a safe,effective and useful technique for resolving symptoms and improving blood flow to the posterior circulation,with a low complication rate and good long-term results.In patients with severe tortuosity of the vessel,stent placement is a real challenge.The new coronary balloon-expandable stents may be preferred.A large variability of restenosis rates has been reported.Drug-eluting stents may be the solution.After a comprehensive review of the literature,it can be concluded that percutaneous angioplasty and stenting of extracranial VA stenosis is technically feasible,but there is insufficient evidence from randomized trials to demonstrate that endovascular management is superior to best medical management.展开更多
Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebr...Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood flow and perfusion in the posterior circulation after interventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic reso- nance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery orifice stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treat- ment only. The intervention group received vertebral artery orifice angioplasty and stenting ＋ identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent functional magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery orifice stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.展开更多
Objective:To describe the clinical fea-tures of a case of ischemic stroke caused by pseudo severe stenosis of vertebral artery(VA).Methods:The clinical history and image data of a 52-year-old man with ischemic stroke ...Objective:To describe the clinical fea-tures of a case of ischemic stroke caused by pseudo severe stenosis of vertebral artery(VA).Methods:The clinical history and image data of a 52-year-old man with ischemic stroke were collected.Results:Computerized tomography angiography(CTA)revealed stenosis of V1 and V4 of the left VA.DSA confirmed that the anterior blood flow recov-ered after stent implantation,and the V4 segment of the left VA was normal without stenosis.Conclusions:It is spec-ulated that the upper stenosis is due to local hemodynamic changes rather than real stenosis.This case suggests that the interpretation of stenosis on CTA should consider cere-bral vascular anatomy and hemodynamic changes.展开更多
To the Editor:Bilateral medial medullary infarction(MMI)is a rare stroke subtype.[1]usually leads to quadriplegia,sensory disturbance,hypoglossal palsy,bulbar paralysis,etc.[2]We encountered a patient with rapidly pro...To the Editor:Bilateral medial medullary infarction(MMI)is a rare stroke subtype.[1]usually leads to quadriplegia,sensory disturbance,hypoglossal palsy,bulbar paralysis,etc.[2]We encountered a patient with rapidly progressive tetraparesis and diffusion-weighted imaging(DWI)exhibited a“heart appearance”sign in the bilateral ventral medulla.Computed tomography angiography(CTA)demonstrated that the left vertebral artery(VA)was hypoplastic and there was an atherosclerotic stenosis in the V4 segment.展开更多
文摘Percutaneous angioplasty and stenting for the treatment of extracranial vertebral artery(VA) stenosis seems a safe,effective and useful technique for resolving symptoms and improving blood flow to the posterior circulation,with a low complication rate and good long-term results.In patients with severe tortuosity of the vessel,stent placement is a real challenge.The new coronary balloon-expandable stents may be preferred.A large variability of restenosis rates has been reported.Drug-eluting stents may be the solution.After a comprehensive review of the literature,it can be concluded that percutaneous angioplasty and stenting of extracranial VA stenosis is technically feasible,but there is insufficient evidence from randomized trials to demonstrate that endovascular management is superior to best medical management.
基金supported by the Natural Science Foundation of Yongchuan District of Chongqing in China,No.Ycstc,2013nc8031the Foundation of Chongqing Municipal Health Bureau in China,No.2010-2-250+1 种基金the Foundation of Chongqing Health and Family Planning Commission in China,No.20143001the Soft Science Foundation of Yongchuan District of Chongqing in China,No.Ycstc,2011BE5004
文摘Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood flow and perfusion in the posterior circulation after interventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic reso- nance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery orifice stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treat- ment only. The intervention group received vertebral artery orifice angioplasty and stenting ＋ identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent functional magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery orifice stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.
基金National Natural Science Foundation of China(82071468,82271507)。
文摘Objective:To describe the clinical fea-tures of a case of ischemic stroke caused by pseudo severe stenosis of vertebral artery(VA).Methods:The clinical history and image data of a 52-year-old man with ischemic stroke were collected.Results:Computerized tomography angiography(CTA)revealed stenosis of V1 and V4 of the left VA.DSA confirmed that the anterior blood flow recov-ered after stent implantation,and the V4 segment of the left VA was normal without stenosis.Conclusions:It is spec-ulated that the upper stenosis is due to local hemodynamic changes rather than real stenosis.This case suggests that the interpretation of stenosis on CTA should consider cere-bral vascular anatomy and hemodynamic changes.
文摘To the Editor:Bilateral medial medullary infarction(MMI)is a rare stroke subtype.[1]usually leads to quadriplegia,sensory disturbance,hypoglossal palsy,bulbar paralysis,etc.[2]We encountered a patient with rapidly progressive tetraparesis and diffusion-weighted imaging(DWI)exhibited a“heart appearance”sign in the bilateral ventral medulla.Computed tomography angiography(CTA)demonstrated that the left vertebral artery(VA)was hypoplastic and there was an atherosclerotic stenosis in the V4 segment.
