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
Objective:To evaluate the values of Carotid Magnetic Resonance Imaging(MRI)in the differential diagnosis of symptomatic carotid stenosis and atherosclerotic plaque.Methods:56 patients with ischemic cerebrovascular dis...Objective:To evaluate the values of Carotid Magnetic Resonance Imaging(MRI)in the differential diagnosis of symptomatic carotid stenosis and atherosclerotic plaque.Methods:56 patients with ischemic cerebrovascular disease admitted in our hospital from October 2018 to October 2019 were selected and treated with Carotid MRI and digital subtraction angiography(DSA)examinations.According to the two examination results recorded and the“gold standard”of DSA examination,values of Carotid MRI in the differential diagnosis of symptomatic carotid stenosis were evaluated.Results:According to the“gold standard”of DSA examination,the sensitivity and specificity of MRI examination for carotid stenosis were:Mild:92.54%and 97.78%;Moderate:85.71%and 88.78%;Severe:100.00%and 97.8%;and complete occlusion:100.00%and 100.00%;The proportions of intraplaque haemorrhage and ruptured fibrous cap in different degrees of carotid artery stenosis were:Mild:30.16%and 22.22%;Moderate:43.48%and 39.13%;And severe:57.89%and 52.63%.Conclusion:MRI examination can evaluate the degree of symptomatic carotid artery stenosis,and show the characteristics of atherosclerotic plaque at the same time to provide a reference for early clinical differential diagnosis and treatment.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.
文摘Objective:To evaluate the values of Carotid Magnetic Resonance Imaging(MRI)in the differential diagnosis of symptomatic carotid stenosis and atherosclerotic plaque.Methods:56 patients with ischemic cerebrovascular disease admitted in our hospital from October 2018 to October 2019 were selected and treated with Carotid MRI and digital subtraction angiography(DSA)examinations.According to the two examination results recorded and the“gold standard”of DSA examination,values of Carotid MRI in the differential diagnosis of symptomatic carotid stenosis were evaluated.Results:According to the“gold standard”of DSA examination,the sensitivity and specificity of MRI examination for carotid stenosis were:Mild:92.54%and 97.78%;Moderate:85.71%and 88.78%;Severe:100.00%and 97.8%;and complete occlusion:100.00%and 100.00%;The proportions of intraplaque haemorrhage and ruptured fibrous cap in different degrees of carotid artery stenosis were:Mild:30.16%and 22.22%;Moderate:43.48%and 39.13%;And severe:57.89%and 52.63%.Conclusion:MRI examination can evaluate the degree of symptomatic carotid artery stenosis,and show the characteristics of atherosclerotic plaque at the same time to provide a reference for early clinical differential diagnosis and treatment.
