Efficacy observation of endovascular therapy and medical therapy for symptomatic intracranial artery stenosis
11.3969/j.issn.1672-5921.2014.06.004
- VernacularTitle:血管内治疗与药物治疗症状性颅内动脉狭窄的疗效比较
- Author:
Yongge HOU
;
Jing WANG
;
Yilong LIU
;
Dongxin WANG
;
Xiaofeng LIU
;
Qian YANG
- Publication Type:Journal Article
- Keywords:
Intracranial arterial disease;
Endovascular procedures;
Stent;
Polypharmacy;
Restenosis
- From:
Chinese Journal of Cerebrovascular Diseases
2014;(6):294-299
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the efficacy comparison of endovascular therapy and simple medical therapy for symptomatic intracranial artery stenosis. Methods A total of 145 patients with intracranial artery stenosis were analyzed retrospectively. They were divided into either an endovascular therapy group (n=72) or a medical therapy group (n=73). They were treated with endovascular therapy (gateway balloon,wingspan stents,Apollo stents) or medical therapy (aspirin 100 mg/d,clopidogrel 75mg/d, and atorvastatin 20-40 mg/d) according the willingness of the patients or their family members. The incidences of stroke and transient ischemic attack ( TIA ) , and restenosis rate ( stenosis rate >50% as a standard) during 1-,3-,6-,9-,and 12-month follow-up periods were observed and compared. Results On the basis of medical therapy,the patients of the endovascular therapy group were successfully stented. The success rate of stenting was 98. 6% (70/71). Seven patients had complications in the endovascular therapy group (9.9%),2 of them complicated with hemorrhage(one of was died),drinking cough,hoarseness, dizziness,headache,and excitement were one case in each, the other patients were cured and discharged with active medical treatment, and they did not have serious sequelae. At 12 months after treatment, the stroke recurrence rate of the endovascular therapy group was 8. 4% (n=6,both were TIA),and that of the medical therapy group was 26. 0% (84. 2% was minor stroke). There was significant difference (χ2 =7. 752,P<0. 01);at 12 months after treatment,the incidences of restenosis and aggravated stenosis were 5. 6% (n=4) and 6. 8% (n=5) respectively. There was no significant difference (χ2 =0. 091,P>0. 05). Conclusion Compared with the medical therapy,the efficacy of endovascular therapy for symptomatic intra-cranial arterial stenosis is more significant. The improvement of clinical prognosis is superior to medical therapy.
