Objective To explore the changes of the levels of Interleukin-6 (IL-6), tumor necrosis factor a (TNF-α) and c-reactive protein (CRP) after carotid artery stenting (CAS) and their relation to restenosis in patients with transient ischemic attack. Methods The patients were divided into group A (with 1 stenting and 1 lesion, n=38) and group B (with 2 stenting and 2 lesions, n=29) according to the pathologic changes and complicated degrees of CAS, and all the patients were divided into restenosis group (n=14) and non-restenosis group (n=48) according to the examination results of cervical CTA 1 y after CAS. The levels of EL-6, TNF-α and CRP were measured before CAS and 1 h, 2 w, 1 and 6 mon, and 1 y after stents. The level of CRP was measured by enhanced immunoturbidirnetic assay, and the levels of IL-6 and TNF-a were measured by radioimmunoassay. Results to the follow-up survey, 1 died and 4 were lost. Fourteen had restenosis of different degrees. The restenosis rate more than 50 percent was noted in 3 patients. Compared to those before CAS, the levels of CRP, IL-6 and TNF-α were increased rapidly after CAS (P<0.05). Compared to those in the group A, the levels of CRP, IL-6 and TNF-α in the group B 1 h, 2 w and 6 mon after CAS were obviously increased (P<0.05). Compared to those in the non-restenosis group, the levels of CRP, IL-6 and TNF-α in the restenosis group 1 h, 2 w and 6 mon after CAS were obviously increased (P<0.05). Conclusion The levels of IL-6, TNF-α and CRP increased rapidly after CAS, then reduced gradually and increased once again 6 months after CAS, which was notable in restenosis group. They can be the reference indexes of the forecast for early restenosis.

Objective To explore the changes of levels of von willebrand (vWF) and endothelin-1 (ET-1) and their relations with restenosis in patients performed carotid artery stenting (CAS).Methods The levels of vWF and ET-1 in 67 patients were measured before CAS and 1 h, 2 w, 1 and 6months, and 1 y after the stenting. All the patients were divided into restenosis group and non-restenosis group according to the examining results of cervical CTA 1 y after CAS. Results In the follow-up survey, 1 patient was died and 4 were out of touch. Fourteen patients had restenosis of different degrees;the restenosis rates of 3 patients was more than 50 percent. The level of vWF 1 h and 6 months after CAS and the level of ET-1 1 h, 2 w and 6 months after CAS were increased rapidly as compared with those before CAS (P<0.05). As compared with those in the on-restenosis group, the level of vWF 1 h, 2 w and 6 months after CAS and the level of ET-1 1 h, 2 w, 1 and 6 months after CAS in the restenosis group were obviously increased (P<0.05). Conclusion The levels of vWF and ET-1 increase continually in a short term (within 2 weeks) after CAS, and increase once again 6 months after CAS which increases the risk of restenosis.Monitoring the levels of vWF and ET-1 may be of great value in judging long-term prognosis.

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.

Anti-Arrhythmia Agents ; Brugada Syndrome/complications* ; Bundle-Branch Block/complications* ; Electrocardiography ; Humans ; Quinidine ; Ventricular Fibrillation