Clinical interference and follow-up studies in patients with symptomatic carotid artery totalocclusion
10.3760/cma.j.issn.1671-8925.2011.11.004
- VernacularTitle:症状性颈内动脉完全闭塞患者的临床干预和随访研究
- Author:
Hua YANG
1
;
Zhang-Yong XIA
;
Min ZHANG
;
Zeng-Guang REN
;
Qin YIN
;
Ge-Lin XU
;
Huai-Qian QU
;
Li WANG
Author Information
1. 山东省聊城市第三人民医院
- Keywords:
Internal carotid;
Vascular occlusion;
Stent;
Follow-up study
- From:
Chinese Journal of Neuromedicine
2011;10(11):1092-1096
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effects of artery-interventional therapy and drug treatment on patients with symptomatic carotid artery total occlusion,and observe the follow-up results of cerebrovascular events after clinical interference.Methods According to patient′s intention,62patients with symptomatic carotid artery total occlusion,admitted to our hospitals from February 2004 to January 2009,were divided into artery-interventional therapy group(n=21)and drug treatment group (n=41).In the artery-interventional therapy group,patients were given revascularization of internal carotid by endovascular intervention.In the drug treatment group,patients were given aspirin,clopidogrel and statins.The major end-point outcome of follow-up survey was the 2-year functional prognosis evaluated by modified Rankin Scale(mRS),and Rank sum test was employed to compare the differences of mean rank of the 2 groups; the minor end-point outcome was the cardiovascular events,and Kaplan-Meier method and multivariate Cox regression were employed to analyze the median time and independent risk factors.Results During the 3,6 and 9 months,1 and 2 years of follow-up,mRS average ranks in the artery-interventional therapy group were statistically lower than those in the drug treatment group(P＜0.05).The median times of recurrence of cardio-cerebrovascular events in the artery-interventional therapy group and drug treatment group were(17.42±1.20)months(95％CI:15.07-19.76)and(19.43±1.51)months(95％CI:16.48-22.38),respectively,and Kaplan-Meier analysis showed no significant difference(P＞0.05).Survival Cox regression analysis showed that independent factors of cardio-cerebrovascular events were smoking(RR=3.189,95％CI:1.020-9.968,P=0.046),diabetes(RR=2.717,95％CI:1.113-6.631,P=0.028),and baseline NIHSS scores(RR=2.984,95％CI:1.049-8.485,P=0.040),but treatment methods(artery-interventional therapy and drug treatment)were not independent factors(RR=1.191,95％CI:0.430-3.296,P=0.737).Conclusion Artery-interventional therapy is superior to drug therapy in achieving better functional prognosis; however,the 2-year-follow-up shows that the artery-interventional therapy can not reduce the occurrence of cardio-eerebrovascular events.Smoking,diabetes and baseline NIHSS scores are independent factors of recurrence of cardio-cerebrovascular events.
