ABSTRACT
@#Objective To investigate the effectiveness and safety of 8F guide catheter combined with other thrombectomy techniques in the thrombectomy treatment of patients with acute internal carotid artery occlusion. Methods From January 2016 to November 2019，we retrospectively analyzed 52 patients data from the Department of Neurology，Guangdong Provincial People’s Hospital，those patients were diagnosed as acute internal carotid artery occlusion results from cardiac cerebral embolism and treated with mechanical thrombectomy. They were divided into observation group and control group in according to whether suction treatment in combination with 8F guide catheter was conducted. Data collected and analyzed between the two groups included age，gender，hypertension，diabetes，Alberta Stroke Program Early CT（ASPECT） score，the United States National Institutes of Health Stroke Scale（NIHSS）score，bridging treatment，onset to puncture time （OTP），puncture to recanalization time （PTR），mechanical thrombectomy technique，number of thrombectomy maneuvers，vascular recanalization，asymptomatic intracranial hemorrhage （aSICH），symptomatic intracranial hemorrhage （SICH），mRS at 90 days after endovascular thrombectomy. Results （1）There were no statistically significant differences in baseline data between the two groups of patients （P>0.05）. （2）There were no statistically significant differences in bridging treatment，OTP，PTR，mechanical thrombectomy technique，aSICH and SICH between the two groups of patients （P>0.05）. The average times of thrombectomy in the observation group and the control group were 2.1 and 3.0 respectively，and the difference between the two groups was statistically significant （P=0.009）. In the observation group，23 cases had successful recanalization，17 cases had good mRS prognosis 90 days after operation，and 11 cases in the control group had successful recanalization，and 7 cases had a good prognosis at 90 days after operation. The difference between the two groups was statistically significant （P<0.05）. Conclusion For patients with acute internal carotid artery occlusion results from cardiac cerebral embolism，the application of 8F guided catheter suction combined with other thrombectomy techniques can improve the effect of thrombectomy. It is a method of mechanical thrombectomy with clinical value.
ABSTRACT
Objective To investigate the relationship between platelet-activating factor acetylhydrolase gene Arg92His(4, 275; G→A), Ile198Thr(7, 593; T→C) and Val279Phe(9, 994; G→T) mutation and cerebral artery athero-sclerosis stenosis. Methods Six hundred forty-twopatients with cerebral infarction underwent cerebral digital subtrac-tion angiography (DSA).The patients were then divided into cerebral artery atherosclerosis stenosis (CAAS) group(n=477) and control group(n=81) accroding to the site and severity of their cerebral artery stenosis. Furthermore, the CAAS group were divided into intracranial artery stenosis(ICAS) subgroup(n=251), extracranial artery stenosis(ECAS) subgroup (n=115) and extracranial-intracerebral artery stenosis(ECAS) subgroup(n=111). The distributions of genotype and allele frequencies of Arg92His,Ile198Thr and Val279Phe mutation of platelet-activating factor acetylhydrolase gene were ex-amined and comparied in different groups. Results There were significant differences in the distributions of genotype and allele of Arg92His mutation between ICAS subgroup and control group(42.6% vs. 30.3%;23.3% vs. 16.4%, P 0.05). The distributions of genotype and allele of Arg92His, Ile198Thr and Val279Phe mutation were no significantly difference between CAAS group and control group (P >0.05). Conclusions Arg92His mutation may be associated with intracranial artery atherosclerotic stenosis.
ABSTRACT
The curative efficacy of percutaneous transluminal angioplasty and stenting (PTAS) in the treatment of patients with ischemia cerebrovascular disease caused by artery stenosis was explored. The clinical data of 111 patients with ischemia cerebrovascular disease receiving PTAS in Guangdong Province General Hospital from Aug. 2007 to Nov. 2009 were retrospectively analyzed. In total 132 stents were implanted in the 111 patients. The mortality and rate of neural and non-neural complications were assessed perioperatively. Outcomes [including the frequency of transient ischemic attack (TIA), stroke, or death from vascular diseases) were assessed after operation. NIHSS rating was performed in all cases before and at first week, 6th month and 12th month after the operation. The PTAS success rate was 100%. The degree of stenosis was reduced after PTAS. The total complication rate during perioperative period was 15.3% (the rate of neural complications was 3.6%). Sixty-seven patients were followed up. Three patients (4.48%) developed cerebrovascular events within 1 month, containing one case of TIA, one case of ipsilateral mild stroke and one case of contralateral mild stroke. No severe stroke or death was observed. During a follow-up period of 12 months 7 patients had cerebrovascular events (10.44%), including 2 cases of ipsilateral TIA (2.99%), 2 cases of ipsilateral mild stroke and 2 cases of contralateral mild stroke (2.99%), one case of severe stroke (1.49%). In 13 patients receiving DSA re-examination one year after PTAS, 2 patients (15.38%) had in-stent restenosis. NIHSS scores were obviously decreased during a follow-up period as compared with those pre-operation (P<0.05). It was concluded that PTAS could significantly alleviate the neural function deficit of the patients with ischemia cerebrovascular disease. The success rate of PTAS was high, and the rate of complications was lower and the clinical outcomes were satisfactory. PTAS is a safe and effective therapeutic method, though the long-term outcomes need further study.