Screening status and prognosis of indications for endovascular therapy in symptomatic intracranial atherosclerotic disease
10.19845/j.cnki.zfysjjbzz.2020.0385
- VernacularTitle: 症状性颅内动脉粥样硬化性病变患者血管内治疗适应证筛查现状及预后分析
- Author:
Honglian XUE
1
;
Wenjun LI
1
;
Pinyuan ZHANG
1
Author Information
1. Department of Neurology,The Third Hospital of Hebei Medical University,Shijiazhuang 050051,China
- Publication Type:Journal Article
- Keywords:
Symptomatic intracranial atherosclerotic disease;
Endovascular therapy;
Multimodal neuroimaging;
Perfusion imaging
- From:
Journal of Apoplexy and Nervous Diseases
2020;37(6):523-526
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the status and prognosis of multimodal neuroimaging screening before endovascular therapy in patients with symptomatic intracranial atherosclerotic disease(sICAD) in the real world.Methods Patients with sICAD,who were hospitalized in our hospital from January 2016 to May 2019,were enrolled in the study retrospectively.The admission criteria was:proximal lesions of anterior circulation artery,stenosis rate ≥70%,baseline NIHSS score ≤20,standard medical therapy within 2 weeks after the onset or angioplasty within 3 months after the onset.The application of multimodal neuroimaging technology before endovascular therapy in the real world was studied,the gap between the current situation and the guidelines of endovascular therapy screening was analyzed.The clinical prognosis of DWI combined with traditional angiographic screening in patients with watershed infarction was evaluated.The clinical and safety outcomes of the patients were followed up and compared with those of the patients treated with standard drugs.Results In this study,all patients received structural imaging examinations such as NCCT/DWI/FLAIR and vascular imaging examinations such as TCD/MRA;Only 5.3% of the 38 endovascular patients received perfusion imaging such as ASL or CTP before surgery.Compared with patients in the standard medical therapy group,the recurrence rate of stroke in the endovascular therapy group were significantly reduced at 6 months and 1 year (P=0.045;P=0.011),and there was no significant difference in intracranial hemorrhage and all-cause mortality between the two groups (P>0.05).Among the watershed infarcts selected by DWI,the 1-year recurrence rate in the endovascular therapy group was significantly lower than that in the standard medical treatment group (P=0.035).The recurrence rate of patients with non-watershed infarcts treated with the two methods was similar (P>0.05).Conclusion The preoperative evaluation of cerebral perfusion in patients with endovascular therapy is not optimal;DWI combined with traditional angiographic examination can clarify the watershed infarct and local cerebral perfusion,and replace perfusion imaging as an indication screening method for endovascular therapy.
- Full text:2024080122444050836Screening status and prognosis of indications for endovascular therapy in symptomatic intracranial atherosclerotic disease.pdf
