Objective To explore the correlation between gait disorders and alterations in diffusion tensor imaging(DTI)parameters in different regions of interest(ROI)and associated white matter tracts in older patients with leukoaraiosis(LA).Methods A total of 108 elderly LA patients admitted in our department from July 2023 to May 2024 were enrolled,and based on the Fazekas scale,they were divided into normal(n=28),moderate(n=48),and severe groups(n=32).Tinetti Gait Scale(TGS)was used to evaluate the morbility and balance function,and Short Physical Performance Battery(SPPB)was employed to assess motor function.All participants underwent brain MRI and DTI scanning.Fractional anisotropy(FA)values were quantitatively measured in predefined ROIs and specific white matter tracts.Results The moderate and severe groups had significantly advanced age and higher homocysteine level,and lower total TGS score,Tinetti gait score,total SPPB score,and walking speed score than the normal group(P＜0.05).The severe group exhibited obviously lower education level,and decreased Tinetti balance score and standing score than the normal and moderate groups(P＜0.05).The FA values at the left pa-rietal lobe,the anterior horn of bilateral lateral ventricles,and the splenium of the left corpus cal-losum were notably lower,so were the FA values at the corpus callosum(left-right),left cortico-spinal tract(inferior segment),left anterior thalamic radiation(inferior segment),left inferior fronto-occipital fasciculus(inferior segment),and left superior longitudinal fasciculus(inferior segment)in the moderate group and the severe group than the normal group(P＜0.05).The se-vere group demonstrated lower FA values at the left and right parietal lobes than the other two groups(P＜0.05).Multivariate logistic regression analysis revealed that the anterior horn of the left lateral ventricle(β=-0.683,P=0.001)and the left inferior corticospinal tract(β=-0.742,P=0.001)were influencing factors for gait disorder in elderly LA patients.Conclusion In elderly LA patients,gait disorders are correlated with decreased FA values in specific ROI and white mat-ter tracts,with the decreased FA values in the anterior horn of the left lateral ventricle and the left inferior corticospinal tract demonstrating the most significant impact.

Objective To explore the correlation between gait disorders and alterations in diffusion tensor imaging(DTI)parameters in different regions of interest(ROI)and associated white matter tracts in older patients with leukoaraiosis(LA).Methods A total of 108 elderly LA patients admitted in our department from July 2023 to May 2024 were enrolled,and based on the Fazekas scale,they were divided into normal(n=28),moderate(n=48),and severe groups(n=32).Tinetti Gait Scale(TGS)was used to evaluate the morbility and balance function,and Short Physical Performance Battery(SPPB)was employed to assess motor function.All participants underwent brain MRI and DTI scanning.Fractional anisotropy(FA)values were quantitatively measured in predefined ROIs and specific white matter tracts.Results The moderate and severe groups had significantly advanced age and higher homocysteine level,and lower total TGS score,Tinetti gait score,total SPPB score,and walking speed score than the normal group(P＜0.05).The severe group exhibited obviously lower education level,and decreased Tinetti balance score and standing score than the normal and moderate groups(P＜0.05).The FA values at the left pa-rietal lobe,the anterior horn of bilateral lateral ventricles,and the splenium of the left corpus cal-losum were notably lower,so were the FA values at the corpus callosum(left-right),left cortico-spinal tract(inferior segment),left anterior thalamic radiation(inferior segment),left inferior fronto-occipital fasciculus(inferior segment),and left superior longitudinal fasciculus(inferior segment)in the moderate group and the severe group than the normal group(P＜0.05).The se-vere group demonstrated lower FA values at the left and right parietal lobes than the other two groups(P＜0.05).Multivariate logistic regression analysis revealed that the anterior horn of the left lateral ventricle(β=-0.683,P=0.001)and the left inferior corticospinal tract(β=-0.742,P=0.001)were influencing factors for gait disorder in elderly LA patients.Conclusion In elderly LA patients,gait disorders are correlated with decreased FA values in specific ROI and white mat-ter tracts,with the decreased FA values in the anterior horn of the left lateral ventricle and the left inferior corticospinal tract demonstrating the most significant impact.

Objective:To analyze the differences of effectiveness of stenting for vertebral artery ostium severe stenosis via transradial access and transfemoral access. Methods:Sixty-three patients with vertebral artery ostium severe stenosis confirmed by cerebral angiography in our hospital from December 2017 to March 2022 were enrolled. Stent implantation via transradial access was performed in 30 patients (radial artery group) and stent implantation via transfemoral access was performed in 33 patients (femoral artery group). The radial artery group was divided into left and right subgroups according to the lesions of vertebral arteries; and according to the anatomical classification of vertebral arteries, radial artery group was divided into two subgroups: anatomical type I and anatomical type II. The baseline data and surgery-related data (success rate of stent implantation, time from sheath insertion to stent implantation, surgical time, exposure time, and incidence of surgical complications) of patients in the radial artery group and femoral artery group were compared and analyzed. The surgical data of patients in the subgroups of radial artery group were compared and analyzed. Results:There was no significant difference in the success rate of stent implantation or incidence of primary endpoint events 3 d after surgery between the radial artery group and femoral artery group ( P>0.05). The time from sheath insertion to stent implantation, surgical time, and exposure time in the radial artery group were statistically shorter than those in the femoral artery group ( P<0.05). The radial artery group had significantly lower incidence of complications (9.01% vs. 30.0%) and incidence of hematoma (3.03% vs. 20.05) at the puncture sites than the femoral artery group ( P<0.05). Time from sheath insertion to stent implantation, surgical time, and exposure time in the anatomical type I patients of radial artery group were significantly longer than those in the anatomical type II patients ( P<0.05); those in patients with left lesions of radial artery group were significantly shorter than those in patients with right lesions ( P<0.05). Conclusion:As compared with that via transfemoral access, the stenting via transradial access has almost the same success rate, without significant difference in incidence of perioperative serious complications, and stenting via transradial access has shorter surgical time, lower surgical difficulty, and lower incidence of complications; patients with anatomical type II or left lesions have better efficacy than those with anatomical type I or right lesions.

Objective:To analyze the differences of effectiveness of stenting for vertebral artery ostium severe stenosis via transradial access and transfemoral access. Methods:Sixty-three patients with vertebral artery ostium severe stenosis confirmed by cerebral angiography in our hospital from December 2017 to March 2022 were enrolled. Stent implantation via transradial access was performed in 30 patients (radial artery group) and stent implantation via transfemoral access was performed in 33 patients (femoral artery group). The radial artery group was divided into left and right subgroups according to the lesions of vertebral arteries; and according to the anatomical classification of vertebral arteries, radial artery group was divided into two subgroups: anatomical type I and anatomical type II. The baseline data and surgery-related data (success rate of stent implantation, time from sheath insertion to stent implantation, surgical time, exposure time, and incidence of surgical complications) of patients in the radial artery group and femoral artery group were compared and analyzed. The surgical data of patients in the subgroups of radial artery group were compared and analyzed. Results:There was no significant difference in the success rate of stent implantation or incidence of primary endpoint events 3 d after surgery between the radial artery group and femoral artery group ( P>0.05). The time from sheath insertion to stent implantation, surgical time, and exposure time in the radial artery group were statistically shorter than those in the femoral artery group ( P<0.05). The radial artery group had significantly lower incidence of complications (9.01% vs. 30.0%) and incidence of hematoma (3.03% vs. 20.05) at the puncture sites than the femoral artery group ( P<0.05). Time from sheath insertion to stent implantation, surgical time, and exposure time in the anatomical type I patients of radial artery group were significantly longer than those in the anatomical type II patients ( P<0.05); those in patients with left lesions of radial artery group were significantly shorter than those in patients with right lesions ( P<0.05). Conclusion:As compared with that via transfemoral access, the stenting via transradial access has almost the same success rate, without significant difference in incidence of perioperative serious complications, and stenting via transradial access has shorter surgical time, lower surgical difficulty, and lower incidence of complications; patients with anatomical type II or left lesions have better efficacy than those with anatomical type I or right lesions.