Risk factors for perioperative ischemic stroke in patients with atherosclerotic cerebrovascular stenosis undergoing percutaneous transluminal angioplasty and stenting
- VernacularTitle:脑血管狭窄行支架植入术围术期缺血性卒中的危险因素
- Author:
Wan ZHAO
1
,
2
;
中国医学科学院阜外医院麻醉科
;
Minyu JIAN
;
Aidong WANG
;
Ruquan HAN
Author Information
1. 100050 首都医科大学附属北京天坛医院麻醉科
2. 中国医学科学院阜外医院麻醉科
- Keywords:
Atherosclerosis;
Cerebrovascular stenosis;
Percutaneous transluminal angioplasty and stenting;
Perioperative ischemic stroke
- From:
The Journal of Clinical Anesthesiology
2017;33(11):1045-1049
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the predictors of perioperative ischemic stroke following percutaneous transluminal angioplasty and stenting.Methods We retrospectively evaluated data on 416 percutaneous transluminal angioplasty and stenting (PTAS) procedures at (334 males,82 females,aged 40-85 years,falling into ASA Ⅰ-Ⅲ) a single institution.Logistic regression was used to analyze the role of clinical,angiographic and hemodynamic variables on periprocedural ischemic strokes.Results Among 328 patients underwent PTAS for the treatment of extracranial stenosis,10 patients (3.0％) had perioperative ischemic stroke.Among the 88 stenting for intracranial stenosis,6 patients (6.8 ％) had perioperative ischemic stroke.Multivariable predictors of perioperative ischemic stroke for stenting for extracranial stenosis were the presence of untreated intracranial artery stenosis (OR =9.44,95％CI 2.36-37.71,P=0.001) and intraoperative absolute minimal SBP＜90 mm Hg (OR=9.13,95％CI 1.35-61.76,P =0.023).The independent predictors of perioperative ischemic stroke following PTAS for intracranial stenosis included the patients' increasing age (OR =1.25,95 ％ CI 1.04-1.51,P=0.021),presence of calcific plaques (OR=11.02,95％CI 1.11-109.25,P=0.040) and untreated intracranial artery stenosis (OR =44.81,95％ CI 1.99-1 011.84,P =0.017).Conclusion For patients with extracranial stenosis,suffering from the presence of untreated intracranial artery stenosis and intraoperative absolute minimal SBP＜90 mm Hg are the independent risk factors for perioperative ischemic stroke.The patients' increasing age,presence of calcific plaques and untreated intracranial artery stenosis were the independent risk factors for this complication in patients with intracranial stenosis.
