RESUMO
The study objective was to investigate the relations between serum endothelin-1 and in-stent restenosis in vertebral artery stenting. Sixty-eight patients undergoing re-examination of vertebral artery stenting in the Department of Cerebrovascular Disease, Hangzhou Third People's Hospital, between April 2019 and October 2022, were invited to participate. According to the presence of vertebral artery stenting, patients were divided into the restenosis (n = 19) or non-restenosis (n = 49) groups. General clinical data and endothelin-1 levels were compared between the groups. Logistic regression analysis was used to explore the relations between endothelin-1 level and risk for in-stent restenosis. Receiver operating characteristic curves were drawn to test the diagnostic value of serum endothelin-1 level for in-stent restenosis. Compared with the non-restenosis group, restenosis group levels of low-density lipoprotein, triglycerides, and endothelin-1 were significantly higher (p < 0.05) Multivariate logistic regression analysis showed that endothelin-1, stent length, and low-density lipoprotein were independently associated with in-stent restenosis (odds ratio = 1.502, 95% confidence interval: 0.042 ~ 0.212, p = 0.000; odds ratio = 1.899, 95% confidence interval: 1.116 ~ 2.237, p = 0.000; odds ratio = 1.899, 95% confidence interval: 1.228 ~ 3.337, p = 0.001, respectively). Area under the curve for serum endothelin-1 in the diagnosis of vertebral artery in-stent restenosis was 0.938. The best diagnostic cut-off value was 11.94 ng/L. Sensitivity was 89.5%. Specificity was 85.7%. These cumulative data indicate that endothelin-1 level is independently associated with in-stent restenosis.
Assuntos
Endotelina-1 , Stents , Artéria Vertebral , Humanos , Endotelina-1/sangue , Masculino , Feminino , Stents/efeitos adversos , Pessoa de Meia-Idade , Idoso , Artéria Vertebral/diagnóstico por imagem , Insuficiência Vertebrobasilar/sangue , Insuficiência Vertebrobasilar/cirurgiaRESUMO
BACKGROUND Vertebral artery origin stenosis (VAOS) has recently gained increased attention, with endovascular treatments like stent implantation showing high success and low complication rates, although less is known about VAOS compared to carotid artery stenosis. This study evaluated the safety and effectiveness of transradial (TRA) and transfemoral (TFA) approaches for VAOS stent placement. MATERIAL AND METHODS We recruited a total of 102 patients undergoing vertebral artery stenting in our hospital between January 2020 and November 2022. Patients were randomly assigned to undergo either radial or femoral approach for stent implantation in the vertebral artery, and the radial approach group secondary divided into 2 groups by patients' consent: ipsilateral or contralateral radial approach. The success rates of VAOS stent implantation, operation time, and postoperative hospitalization time were compared between the 3 groups. In addition, we compared the outcomes of stroke within 30 days, transient ischemic attack (TIA) within 30 days, and other indicators. RESULTS Of the 102 patients, the final success rate of stent implantation was not significantly different between the 3 groups. The time from sheath insertion to stent insertion in the ipsilateral TRA group (median time: 19 min [interquartile range (IQR): 12-24.5 min]) was significantly shorter than in the transfemoral approach (TFA) group (median time: 29 min [IQR: 21-35.5 min]) (P<0.01; 95% confidence interval (95% CI): 10 min [6-14 min]). There were no statistically significant differences between the 3 groups in terms of cerebrovascular events within 1 month, and patient satisfaction and preference favored the radial approach. CONCLUSIONS The postoperative hospitalization time and operation time associated with the ipsilateral TRA were shorter, and patient acceptance and satisfaction were higher.
Assuntos
Procedimentos Endovasculares , Artéria Femoral , Artéria Radial , Stents , Artéria Vertebral , Humanos , Feminino , Masculino , Artéria Radial/cirurgia , Artéria Femoral/cirurgia , Estudos Prospectivos , Pessoa de Meia-Idade , Idoso , Artéria Vertebral/cirurgia , Procedimentos Endovasculares/métodos , Resultado do Tratamento , Insuficiência Vertebrobasilar/cirurgiaRESUMO
BACKGROUND Cerebral hypoperfusion syndrome (CHS) includes a spectrum of clinical symptoms, ranging from focal neurologic deficit to intracerebral hemorrhage. CHS was initially described as a complication of carotid endarterectomy but also occurs following carotid artery stenting. This retrospective study included 320 patients treated with carotid artery stenting at 4 general hospitals in Zhejiang Province between June 2019 and June 2021 and aimed to establish a risk score for CHS. MATERIAL AND METHODS Through retrospective case analysis, a risk model and scoring model for CHS were established and evaluated. RESULTS Poor integrity of the circle of Willis, preoperative cerebrovascular resistance, mean transit time, peak time at CTP, and preoperative cerebral circulation time were significant in the univariate analysis and were entered into the regression equation to establish the logistic and additive scoring model for predicting the risk of CHS after carotid stenting. The area under the receiver operating characteristic (ROC) curve of the logistic scoring system for the early warning risk of CHS after carotid stenting was 0.964 (95% confidence interval [CI] [0.931-0.996]), and the area under the ROC curve of the CHS early risk additive scoring model after carotid stenting was 0.968 (95% CI [0.936-1.000]), The Hosmer-Lemeshow test chi-square values were 0.037 (P=0.848) and 2.671 (P=0.102). CONCLUSIONS Two methods of scoring risk for CHS were developed from a retrospective analysis of 320 patients treated with carotid artery stenting at 4 general hospitals in Zhejian Province between June 2019 and June 2021.
Assuntos
Estenose das Carótidas , Transtornos Cerebrovasculares , Endarterectomia das Carótidas , Artérias Carótidas/cirurgia , Estenose das Carótidas/complicações , Circulação Cerebrovascular , Transtornos Cerebrovasculares/etiologia , Endarterectomia das Carótidas/efeitos adversos , Hospitais Gerais , Humanos , Estudos Retrospectivos , Fatores de Risco , Stents/efeitos adversos , SíndromeRESUMO
OBJECTIVES: Serum ischemia-modified albumin (IMA) is higher in patients with cerebral infarction (CI). In this study, we aimed at studying the association between IMA and CI. METHODS: Patients with CI were divided to severe stenosis group and mild stenosis group according to the stenosis of vertebrobasilar artery. Digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) were used for diagnosis. Cobalt-combined with Albumin test was used to determine the serum IMA levels. Serum IMA levels in patients with CI and healthy volunteers were compared by t test. Receiver operating characteristic (ROC) curve was performed for evaluating the diagnostic efficiency of serum IMA for CI. The correlation between IMA level and the National Institute of Health Stroke Scale(NIHSS) score after treatment was analyzed. RESULTS: Serum IMA levels in patients with CI was increased compared to healthy volunteers(P < .05). Patients in severe stenosis group had a higher serum IMA level than mild stenosis group(P < .05). Serum IMA level at admission was associated with NIHSS score on the 7th day after treatment(P < .05). CONCLUSIONS: Serum IMA level was correlated with vertebrobasilar artery stenosis and short-term prognosis in patients with acute CI.
Assuntos
Albumina Sérica , Insuficiência Vertebrobasilar , Biomarcadores , Infarto Cerebral/diagnóstico por imagem , Constrição Patológica , Humanos , Albumina Sérica Humana , Insuficiência Vertebrobasilar/diagnóstico por imagemRESUMO
BACKGROUND Cerebral artery stenosis is closely related to cognitive function, and angioplasty can improve the cognitive function of elderly patients with vertebrobasilar artery stenosis. The specific mechanism, however, is not clear. This study explored the effect of angioplasty on cellular metabolism in the hippocampus of elderly patients with symptomatic vertebrobasilar artery stenosis. MATERIAL AND METHODS Eighteen elderly patients with symptomatic vertebrobasilar artery stenosis who underwent endovascular stent-assisted angioplasty (ESAA) in our department were studied. The changes in cellular metabolism (NAA / Cr, CHO / Cr, NAA / CHO) in bilateral hippocampal areas were detected by MRS before and at 6 months and 12 months after the ESAA. The Montreal Cognitive Assessment Scale (MoCA), Hamilton Depression Self-assessment Scale (HAMD), and Hamilton Anxiety Self-assessment Scale (HAMA) were also used to evaluate the cognition, depression, and anxiety of patients at different time points of the study, and analyzed the correlation between the changes of cellular metabolism in the hippocampus and the scores of MoCA, HAMD, and HAMA. RESULTS The levels of NAA/Cr in left/right hippocampal areas were significantly higher at 6 and 12 months after the ESAA than before (1.01±0.17/1.22±0.26 vs. 1.10±0.20/1.05±0.26 vs. 0.82±0.10/0.84±0.11, respectively) (P<0.01). MoCA scores were positively correlated with the levels of NAA/Cr in the left/right hippocampal areas (P<0.05 and P<0.01, respectively). CONCLUSIONS ESAA can improve cognitive function of patients by changing the cellular metabolism of the hippocampus in elderly patients with symptomatic vertebrobasilar artery stenosis.
Assuntos
Angioplastia/métodos , Hipocampo/metabolismo , Insuficiência Vertebrobasilar/cirurgia , Idoso , Idoso de 80 Anos ou mais , Artérias/cirurgia , Ácido Aspártico/análogos & derivados , Ácido Aspártico/análise , Encéfalo/metabolismo , Cognição/fisiologia , Constrição Patológica/cirurgia , Creatina/análise , Feminino , Humanos , Espectroscopia de Ressonância Magnética/métodos , Masculino , Neurotransmissores/análise , Stents , Doenças Vasculares/fisiopatologia , Doenças Vasculares/cirurgiaRESUMO
BACKGROUND: The aim of this study was to investigate the influence of carotid artery stenting (CAS) on the cognition and quality of life of elderly patients with severe stenosis of the internal carotid artery. MATERIAL/METHODS: 65 elderly patients with symptomatic severe stenosis of internal carotid artery were recruited into 2 groups: the pharmacotherapy group (n=29) and the CAS group (n=36). Before surgery and 1, 3, 6, and 12 months after surgery, Montreal cognitive assessment (MoCA) was used for the evaluation of cognition and WHOQOL-BREF was used for the assessment of quality of life. RESULTS: At 12 months after surgery, total MoCA score and WHOQOL-BREF score in the pharmacotherapy group was significantly reduced when compared with those before surgery (P<0.05). In the CAS group, the total MoCA score, scores of attention and delayed recall, and WHOQOL-BREF score increased significantly at different time points after surgery when compared with those before surgery (P<0.05). Moreover, in CAS group, the MoCA score and WHOQOL-BREF markedly increased gradually over time (P<0.05). Compared with the pharmacotherapy group, cognition and quality of life in the CAS group were improved dramatically during the follow-up period (P<0.05). CONCLUSIONS: Severe stenosis of the internal carotid artery is a cause of cognition impairment, and CAS may improve cognition and quality of life.
Assuntos
Angioplastia/efeitos adversos , Estenose das Carótidas/tratamento farmacológico , Estenose das Carótidas/cirurgia , Cognição/fisiologia , Qualidade de Vida/psicologia , Stents , Idoso , Análise de Variância , Aspirina/uso terapêutico , Atorvastatina , China , Clopidogrel , Feminino , Ácidos Heptanoicos/uso terapêutico , Humanos , Masculino , Pirróis/uso terapêutico , Fluxo Sanguíneo Regional/fisiologia , Ticlopidina/análogos & derivados , Ticlopidina/uso terapêutico , Resultado do Tratamento , Ultrassonografia Doppler TranscranianaRESUMO
BACKGROUND: We aimed to investigate cognitive function and affective disorder in elderly patients with symptomatic vertebrobasilar artery stenosis (SVAS) after stent-assisted angioplasty (SAA) and to explore the potential mechanism. MATERIAL AND METHODS: The study subjects were 26 elderly SVAS patients who were non-responsive to pharmacotherapy and received SAA (study group) and 30 patients receiving intracoronary stent implantation (control group). Montreal cognitive assessment (MoCA), Hamilton depression rating scale (HAMD), and Hamilton anxiety rating scale (HAMA) were used. RESULTS: The total MoCA score, scores of line connection, copying cube, drawing clock, and delayed recall increased significantly in the study group after surgery (P<0.05, P<0.01). In addition, the MoCA score increased over time and the total MoCA score at 12 months was markedly higher than that at 1 month (P<0.05). The scores of HAMD and HAMA decreased dramatically after surgery compared with before surgery in these patients (P<0.01). A comparison at the corresponding period was performed between study group and control group, and it was found that the differences in total MoCA scores and scores of line connection, copying cube, drawing clock, and delayed recall before surgery and at 1 month after surgery were significant (P<0.05, P<0.01). CONCLUSIONS: SAA may improve the visuospatial/executive abilities and delayed recall, as well as the depression and anxiety in patients with SVAS. Larger and controlled trails are needed to investigate the effect of SAA on cognition and affection in these patients.
Assuntos
Angioplastia , Arteriopatias Oclusivas/terapia , Artéria Basilar/fisiopatologia , Cognição/fisiologia , Transtornos do Humor/fisiopatologia , Stents , Artéria Vertebral/fisiopatologia , Idoso , Angioplastia/efeitos adversos , Arteriopatias Oclusivas/fisiopatologia , Artéria Basilar/patologia , Velocidade do Fluxo Sanguíneo , Estudos de Casos e Controles , Constrição Patológica , Feminino , Humanos , Masculino , Testes Neuropsicológicos , Complicações Pós-Operatórias/etiologia , Recidiva , Fluxo Sanguíneo Regional , Stents/efeitos adversos , Acidente Vascular Cerebral/etiologia , Artéria Vertebral/patologiaRESUMO
OBJECTIVES: This study aimed to explore the correlation between Fibroblast Growth Factor-23 (FGF23) levels and Cerebral Infarction (CI), and to determine whether there is a significant relationship between FGF23 and the occurrence and severity of CI. METHODS: The study categorized Cerebral Infarction (CI) patients into severe and mild stenosis groups based on vertebrobasilar artery stenosis, using Digital Subtraction Angiography (DSA) and Magnetic Resonance Imaging (MRI). The study compared the levels of Fibroblast Growth Factor-23 (FGF23) in the serum of CI patients and healthy controls using a t-test and evaluated the diagnostic effectiveness of serum FGF23 using a Receiver Operating Characteristic (ROC) curve. Additionally, the study analyzed the correlation between FGF23 levels and CI severity after treatment using the National Institute of Health Stroke Scale score. RESULTS: The study found a significant increase in serum Fibroblast Growth Factor-23 (FGF23) levels in patients with Cerebral Infarction (CI) compared to healthy volunteers, (p < 0.001). A higher serum FGF23 level was observed in the severe stenosis group than in the mild stenosis group (p < 0.001). Furthermore, the study showed that a high FGF23 level at admission was significantly related to more severe symptoms of CI as indicated by the National Institute of Health Stroke Scale (NIHSS) score on the 7th day after treatment (p < 0.001). CONCLUSIONS: This study discovered a correlation between Fibroblast Growth Factor-23 (FGF23) levels, vertebrobasilar artery stenosis, and short-term prognosis in patients who had recently experienced acute Cerebral Infarction (CI).
Assuntos
Infarto Cerebral , Fator de Crescimento de Fibroblastos 23 , Fatores de Crescimento de Fibroblastos , Índice de Gravidade de Doença , Insuficiência Vertebrobasilar , Humanos , Insuficiência Vertebrobasilar/sangue , Insuficiência Vertebrobasilar/diagnóstico por imagem , Infarto Cerebral/sangue , Infarto Cerebral/diagnóstico por imagem , Feminino , Masculino , Fatores de Crescimento de Fibroblastos/sangue , Pessoa de Meia-Idade , Idoso , Estudos de Casos e Controles , Imageamento por Ressonância Magnética , Angiografia Digital , Biomarcadores/sangue , Curva ROC , Adulto , Valores de ReferênciaRESUMO
BACKGROUND: Studies have shown that the overall incidence rate of herpeszoster (HZ) in China is 6.64 cases per 1000 people, despite such harms brought by postherpetic neuralgia (PHN), the mechanism of the disease remains unclear in China. Currently, effective biomarkers to predict PHN remain unavailable, which makes it difficult to prevent and successfully treat PHN. OBJECTIVE: The aim of the study was to determine the serum interleukin-6 level in PHN. METHODS: The serum levels of interleukin 6 (IL-6) were measured by multi-antibody sandwich ELISA. The likert scale was used to represent the degree of neuralgia in the patients. Patients with PHN were divided into a mild PHN group and a severe PHN group according to the Likert scale. ROC curve was performed for evaluating the diagnostic efficiency of IL6 for PHN. The correlation between the IL6 level and the Likert scale before and after treatment with gabapentin and mecobalamin was analyzed. RESULTS: IL6 levels in PHN patients resulted higher compared to volunteers. Patients in the severe PHN group had a higher serum IL6 level than in the mild PHN group. The Likert scale score was related to the serum IL6 levels and the frequency of IL6 levels above the cutoff value (4.95â¯pg/mL) in PNH groups before and after treatment (pâ¯<â¯0.05). STUDY LIMITATIONS: Pain is subjective. Some mental states, such as anxiety and depression, greatly influence an individual's perception of pain, and pain tolerance can vary between people. Therefore, pain scores can be affected by different individual factors. CONCLUSIONS: The serum IL6 levels may be used as a biochemical indicator of the severity of PNH.
Assuntos
Herpes Zoster , Neuralgia Pós-Herpética , Humanos , Gabapentina , Herpes Zoster/complicações , Herpes Zoster/tratamento farmacológico , Interleucina-6 , Neuralgia Pós-Herpética/tratamento farmacológico , Neuralgia Pós-Herpética/epidemiologia , Neuralgia Pós-Herpética/etiologia , Estudos RetrospectivosRESUMO
OBJECTIVE: To observe the clinical efficacy of Maixuekang capsule in reconvalescents of cerebral infarction and its impact on coagulation function. METHOD: One hundred and twenty cases of reconvalescents of cerebral infarction were randomly divided into treatment and control groups. The 50 cases in the control group were provided with conventional therapy, while the 70 cases in the treatment group were provided with the combination of conventional therapy and Maixuekang capsule for 3 months. Their neurological function and prothrombin time (PT), activated partial thromboplastin time (APTT) clotting enzyme time (TT), fibrinogen (Fib) were measured before and after treatment. RESULT: After the treatment, PT, APTT and TT were prolonged compared with those before the treatment in the treatment group (P<0.05), whereas Fib, neurological deficit scores decreased (P<0.01) and significantly different from the control group (P<0.05). CONCLUSION: Maixuekang capsule is among safe and effective drugs in treatment of reconvalescents of cerebral infarction, and can improve the patient's coagulation state.
Assuntos
Infarto Cerebral/tratamento farmacológico , Medicamentos de Ervas Chinesas/administração & dosagem , Idoso , Coagulação Sanguínea/efeitos dos fármacos , Cápsulas/uso terapêutico , Infarto Cerebral/metabolismo , Infarto Cerebral/fisiopatologia , Medicamentos de Ervas Chinesas/efeitos adversos , Feminino , Fibrinogênio/metabolismo , Humanos , Masculino , Tempo de ProtrombinaRESUMO
We studied the changes and clinical significance of the serum neuron-specific enolase (NSE) level in peripheral blood of patients with post-herpetic neuralgia (PHN). Material and methods: Patients with PHN were divided into a mild PHN group and a severe PHN group according to their scores on a 100-point Likert scale representing the degree of neuralgia. NSE levels in neuralgia patients and healthy volunteers were then compared by t-test. Receiver operating characteristic curve analysis was performed to evaluate the diagnostic efficiency of NSE for PHN. The correlation between NSE level and Likert scale score after treatment was analyzed. Results: NSE levels in PHN patients were higher than those in the healthy volunteers. Patients in the severe PHN group had higher NSE levels than those in the mild PHN group. NSE level at admission was associated with the Likert scale score recorded on the 14th day of treatment (136.1 ± 32.81 vs. 87.53 ± 16.23 pg/mL) (P < 0.05). The ROC curve of NSE levels for PHN is shown that the area was 0.8713 (95% confidence interval, 0.7861-0.9564; p < 0.0001). Conclusions: There was a correlation between NSE and PHN, in that the NSE level positively correlated with the short-term prognosis of patients with PHN.
Assuntos
Herpes Zoster , Neuralgia Pós-Herpética , Neuralgia , Humanos , Estudos Retrospectivos , Neuralgia Pós-Herpética/complicações , Fosfopiruvato Hidratase , HospitaisRESUMO
BACKGROUND: With the rapid development of precision medicine, targeted therapy has brought new hope for patients with advanced lung cancer. However, because of the high specificity of targeted therapy, individual differences in treatment have occurred, and drug resistance has led to treatment failure, or unpredictable serious side effects have resulted in reducing or stopping treatment. Such outcomes reduce hope. OBJECTIVE: The aim of this study was to understand the phenomena of existential worry and hope in patients with advanced non-small-cell lung cancer (NSCLC) who are receiving targeted therapies. METHODS: The interpretative phenomenological analysis method was used in this study. Semistructured interviews were conducted with patients with advanced NSCLC who had received targeted drug therapy at a public cancer hospital in China. RESULTS: Four themes emerged from the descriptions of 16 patients regarding their psychological experiences of undergoing targeted therapy: wishes and concerns, hopes and fears, expectations and worry, and desires and anxiety. CONCLUSIONS: Non-small-cell lung cancer patients experience positive emotions, such as hope and expectation, as well as negative emotions, such as worry and anxiety, while receiving targeted drug therapy. These different emotions can be experienced concurrently. IMPLICATIONS FOR PRACTICE: Our findings illuminate NSCLC patients' psychological perceptions while undergoing targeted drug therapy. Supportive care resources and interventions are required to enhance patients' positive feelings and reduce their worry during targeted therapy. Patients also require better preparation and information to enable them to improve their quality of life and remain safe after undergoing treatment.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Ansiedade/psicologia , Transtornos de Ansiedade , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/psicologia , Qualidade de VidaRESUMO
Cerebral ischemic stroke (CIS) is the most common type of stroke, which is highly hazardous. This investigation aims to analyze the correlation of miR-497 with CIS, so as to provide reliable evidence for clinical response to CIS and lay a solid foundation for follow-up research. Eighty-nine CIS patients and 39 concurrent physical examinees selected between June 2017 and October 2018 were enrolled as the research participants. Additionally, SD rats with increased miR-497 expression and normal SD rats were purchased for CIS modeling to observe the clinical implications of miR-497 in CIS, as well as the water content of brain tissue and neuronal apoptosis of rats. miR-497 expression was lower in CIS patients than in physical examinees, and that in patients with complete stroke (CS) was the lowest, which increased after treatment. As determined by the receiver operating characteristic curve (ROC) analysis, miR-497 had an outstanding diagnostic efficacy for CIS and was negatively correlated with the National Institutes of Health Stroke Scale (NIHSS) and MDA concentration, while positively related to SOD concentration. Prognostic follow-up demonstrated that decreased miR-497 expression in patients after treatment predicted an increased risk of prognostic death and recurrence. However, observed in rats, the water content of the brain tissue of rats with increased miR-497 expression was reduced, and the neuronal apoptosis rate of the brain tissue was inhibited. Taken together, with low expression in CIS, miR-497 is strongly related to CIS progression and is a candidate CIS marker.
Assuntos
AVC Isquêmico , MicroRNAs/genética , Idoso , Animais , Apoptose/genética , Encéfalo/citologia , Encéfalo/metabolismo , Feminino , Humanos , AVC Isquêmico/diagnóstico , AVC Isquêmico/genética , AVC Isquêmico/metabolismo , AVC Isquêmico/mortalidade , Masculino , MicroRNAs/sangue , MicroRNAs/metabolismo , Pessoa de Meia-Idade , Estresse Oxidativo/genética , Prognóstico , Ratos , Ratos Sprague-DawleyRESUMO
Abstract Background: Studies have shown that the overall incidence rate of herpeszoster (HZ) in China is 6.64 cases per 1000 people, despite such harms brought by postherpetic neuralgia (PHN), the mechanism of the disease remains unclear in China. Currently, effective biomarkers to predict PHN remain unavailable, which makes it difficult to prevent and successfully treat PHN. Objectives: The aim of the study was to determine the serum interleukin-6 level in PHN. Methods: The serum levels of interleukin 6 (IL-6) were measured by multi-antibody sandwich ELISA. The likert scale was used to represent the degree of neuralgia in the patients. Patients with PHN were divided into a mild PHN group and a severe PHN group according to the Likert scale. ROC curve was performed for evaluating the diagnostic efficiency of IL6 for PHN. The correlation between the IL6 level and the Likert scale before and after treatment with gabapentin and mecobalamin was analyzed. Results: IL6 levels in PHN patients resulted higher compared to volunteers. Patients in the severe PHN group had a higher serum IL6 level than in the mild PHN group. The Likert scale score was related to the serum IL6 levels and the frequency of IL6 levels above the cutoff value (4.95pg/mL) in PNH groups before and after treatment (p<0.05). Study limitations: Pain is subjective. Some mental states, such as anxiety and depression, greatly influence an individual's perception of pain, and pain tolerance can vary between people. Therefore, pain scores can be affected by different individual factors. Conclusions: The serum IL6 levels may be used as a biochemical indicator of the severity of PNH.
RESUMO
Objective Endovascular stent-assistant angioplasty (ESAA) is a valid treatment for symptomatic vertebrobasilar artery stenosis (SVAS), but the long-term effect and the improvement of condition compared with medication treatment are unknown. This study investigated the long-term efficacy of ESAA in patients with moderate and severe SVAS, and compared the efficacy with medication treatment. Materials and methods We conducted a retrospective analysis of clinical data of 43 patients with moderate and severe SVAS hospitalized in our department. According to different treatment methods they were divided into 29 cases in an ESAA group and 14 cases in a medication treatment group. During the follow-up period, the degree of vascular stenosis, vascular blood flow velocity, restenosis rate, recovery of neurological function and the incidence of cerebral ischemic events in the two groups were analyzed. Results The average clinical follow-up period was 89.4 ± 10.2 months. Before treatment, the stenosis rate and average blood flow velocity of the two groups were not statistically significant ( p > 0.05). During the follow-up period, both were significantly lower than the medication treatment group ( p < 0.01). In the ESAA group, three cases of stent stenosis, and three cases in the medication treatment group were completely occluded. The total ischemic events in ESAA group were three cases, compared with nine cases in the medication treatment group; the difference was statistically significant ( p < 0.05). Conclusion ESAA has a long-term effect in the treatment of symptomatic moderate and severe vertebrobasilar artery stenosis. It is superior to medication therapy in preventing posterior circulation ischemia (PCI), but a larger sample size is still needed to confirm the study.
Assuntos
Stents , Insuficiência Vertebrobasilar/diagnóstico por imagem , Insuficiência Vertebrobasilar/cirurgia , Idoso , Angiografia Digital , Velocidade do Fluxo Sanguíneo , Angiografia Cerebral , Feminino , Seguimentos , Humanos , Masculino , Recuperação de Função Fisiológica , Recidiva , Estudos Retrospectivos , Resultado do TratamentoRESUMO
OBJECTIVE: To study the efficacy, safety, and feasibility of stent-assistant angioplasty (SAA) in the treatment of symptomatic vertebrobasilar artery stenosis in the elderly. METHODS: SAA was performed in 26 elderly patients with symptomatic vertebrobasilar artery stenosis. The success rate, perioperative complications, and long-term effectiveness were evaluated. RESULTS: A total of 29 balloon expandable stents were implanted in these patients. The success ratio was 100%. The degree of stenosis decreased from 81.3 ± 8.8% to 3.7 ± 3.6% (p < 0.01). Complications were absent during the perioperative period. Follow-up was performed for seven to 36 months (median: 21.9 months). Two patients developed the recurrent symptoms of vertebrobasilar artery stenosis, and no cerebral ischemic events were noted in the remaining patients, suggesting a favorable outcome. CONCLUSION: SAA is a safe and effective strategy for the treatment of symptomatic vertebrobasilar artery stenosis in the elderly.
Assuntos
Angioplastia com Balão/métodos , Prótese Vascular , Stents , Insuficiência Vertebrobasilar/terapia , Idoso , Angioplastia com Balão/efeitos adversos , Velocidade do Fluxo Sanguíneo , Constrição Patológica , Estudos de Viabilidade , Feminino , Seguimentos , Humanos , Masculino , Cuidados Pré-Operatórios , Estudos RetrospectivosRESUMO
OBJECTIVE: To study the efficacy, safety, and feasibility of stent-assistant angioplasty (SAA) in the treatment of symptomatic vertebrobasilar artery stenosis in the elderly. METHODS: SAA was performed in 26 elderly patients with symptomatic vertebrobasilar artery stenosis. The success rate, perioperative complications, and long-term effectiveness were evaluated. RESULTS: A total of 29 balloon expandable stents were implanted in these patients. The success ratio was 100%. The degree of stenosis decreased from 81.3 ± 8.8% to 3.7 ± 3.6% (p < 0.01). Complications were absent during the perioperative period. Follow-up was performed for seven to 36 months (median: 21.9 months). Two patients developed the recurrent symptoms of vertebrobasilar artery stenosis, and no cerebral ischemic events were noted in the remaining patients, suggesting a favorable outcome. CONCLUSION: SAA is a safe and effective strategy for the treatment of symptomatic vertebrobasilar artery stenosis in the elderly.