Difference of diagnosis by CT angiography and DSA for patients with vertebral artery stenosis and efficacy observation of stenting
10.3760/cma.j.issn.1671-8925.2012.12.014
- VernacularTitle:椎动脉狭窄颈部CTA与DSA诊断差异及支架治疗疗效观察
- Author:
Jin ZHOU
1
;
Yong YANG
;
Wei-Hua DENG
;
Hui HUANG
;
Xiao-Pin PAN
Author Information
1. 510180,广州市第一人民医院神经内科
- Keywords:
Vertebral artery stenosis;
Ischemic stroke;
CT Angiography;
Digital subtraction angiography;
Stenting and angioplasty
- From:
Chinese Journal of Neuromedicine
2012;11(12):1247-1250
- CountryChina
- Language:Chinese
-
Abstract:
Objective To observe the significance of neck CT angiography (CTA) in detecting the vertebral artery stenosis,and to study the feasibility and safety of stenting and angioplasty in patients with symptomatic vertebral artery stenosis.Methods Patients with ischemic stroke in the posterior circulation,admitted to our hospital from May 2007 to April 2011,were chosen in our study; all the patients were performed neck CTA and brain MRA; If there might be vertebral artery stenosis in the CTA,DSA was chosen.Patients diagnosed as having vertebral artery stenosis by DSA were performed stenting and angioplasty after being individual assessment and informed consent.Results Thirty-eight patients diagnosed as having ischemia in the posterior circulation and vertebral artery stenosis were received stenting and angioplasty.There were 38 vertebral artery stenoses (above 50％) detected by neck CTA in 29 patients,among which,30 stenoses were in the V1 part of vertebral artery and 8 in the V4 part; while these 29 patients detected by DSA only showed 4 stenoses in the V4 part and 28 in the V1 part (above 50％).And 9 patients with VI part of vertebral artery stenosis (above 50％) couldn't be found by neck CTA but diagnosed by DSA finally.These 38 patients treated with 41 stents,which were all successful (achievement ratio 100％).The mean ratio of stenosis before stenting was (65.0±11.2)％ and the mean ratio after stenting was (11.6±8.9)％,with significant difference.One patient experienced lacunar infarction and 1 severe stroke with lock in syndrome during the 6-25 months of follow-up; and 1 patient experienced subarachnoid hemorrhage after the procedure.Conclusion The neck CTA is useful in the screening of vertebral artery stenosis.Stenting and angioplasty are the safe and effective treatments for patients with symptomatic vertebral artery stenosis.
