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Chinese Journal of Diagnostics(Electronic Edition) ›› 2014, Vol. 02 ›› Issue (01): 17-23. doi: 10.3877/cma.j.issn.2095-655X.2014.01.003

Special Issue:

• Imaging Studies • Previous Articles     Next Articles

Interventional diagnosis and therapy on ischemic stroke with extracranial carotid artery stenosis

Lili Zhao1,(), Xiaojun Cheng2, Heng Chen1, Huanfang Fan1, Liying Hou1, Feng Gao3   

  1. 1. Department of Neurology.Changzhi People′s Hospital Affiliated to Shanxi Medical University, Shanxi 046000, China
  • Received:2013-11-30 Online:2014-02-26 Published:2014-02-26
  • Contact: Lili Zhao
  • About author:
    Corresponding author: Zhao Lili, Email:

Abstract:

Objective

To explore and discuss the interventional diagnosis and therapy of ischemic stroke with extracranial carotid artery stenosis in Changzhi district Shanxi Province.

Methods

Patients with acute ischemic stroke from January 2008 to December 2013 were recruited in Department of Neurology in Changzhi People′s Hospital Shanxi Province.Patients with carotid stenosis were screened out by noninvasive examination firstly, then given DSA to confirm the diagnosis after the consent of the patients.Patients with interventional therapy indication were distributed into intervention group and non-intervention group. All the patients′ neural function were evaluated with NIHSS score before treatment, and followed up at 3 months, 6 months, 1 year and 2 years respectively after discharge.The recurrence was observed, and Modified RanKin Scale score (MRS) was used to evaluate the survival quality.

Results

Seventy-two patients with suspitious cervical angiostenosis were detected DSA in total.The results suggested that 31 had stenosis in extracranial caroti, 14 in vertebral artery, 13 in subclavian artery, 10 in intracranial intracervical artery system and 17 in intracranial vertebrolbasilar system. Among the patients, 25 had multiple stenosis. Thirty-six patients conformed to the indications of intervention therapy in total, which 16 received intervention therapy(treatment group) and 20 cases as control (the control group). Among all the sixteen patients, fifteen stent placement and one balloon dilatation were performed, without any serious complication or death. Compared with control group, patients in the interventional therapy group had lower recurrence rate(χ2=8.23, P=0.004), and were in better functional status(χ2=8.22, P=0.004).

Conclusions

In Changzhi district, the vasculopathy of anterior circulation infarction mainly occurs as stenosis at the initial part of internal carotid artery.The posterior circulation infarction mainly occurs at initial part of vertebral artery, then as the subclavian steal syndrome at the initial part of the subclavian artery.Stenosis of intracranial vertebral artery is also common in posterior circulation infarction. Based on strictly therapeutic indications, intervention therapy was related with a better prognosis in ischemic stroke patients with extracranial carotid artery stenosis.

Key words: Brain ischemia, Stroke, Carotid stenosis, Vertebrobasilar insufficiency, Stents

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