Efiicacy And Prognosis Of Simultaneous Interventional Therapy In Treatment Of Coexistent Cerebrovascular Stenosis And Coronary Heart Disease

Objective:Atherosclerosis is a chronic progressive disease that mainly affects large and medium arteries of the whole body.Cerebrovascular stenosis and coronary heart disease are the common and severe form of atherosclerosis.With aging of the population and rapid transformation of urbanization process,the risk factors of atherosclerosis significantly higher.The popular trend of cerebrovascular stenosis and coronary heart disease sustainly grow in our country,and the burden of cerebrovascular and coronary heart disease continues to increase.Prevention and treatment of cerebrovascular and coronary heart disease become difficuties faced our country.In the future,China will face more aggrevate situation of cerebrovascular and cardiovascular.At present,there is still a controversy about the treatment stratagy of cerebrovascular stenosis combined with coronary heart disease in the world.In order to investigate the efiicacy and prognosis of simultaneous interventional therapy in treatment of coexistent cerebrovascular stenosis and coronary heart disease.The report is as follows.Methods:From September 2017 to September 2019,a total of 23 consecutive in-patients of coexistent cerebrovascular stenosis and coronary heart disease were enrolled retrospectively in the Department of Neurosurgery,Cardiovascular Hospital,Shanxi province.To explore the efficacy of interventional operation,endpoint and follow-up results.All patients were followed up by angiography in 3 months after operation.Results:(1)The operative success rate of 23 patiens was 100%.A total of 23 target cerebral vessels were treated with a balloon recanalization and stenting.And 23 carotid stents were implanted,including 15 internal carotid artery(ICA)(65.2%),12 extracranial ICA(52.2%)and 3 intracranial ICA(13.0%),8 vertebral artery(VA)(34.8%),5 extracranial VA(21.7%)and 3 intracranial VA(13.0%).34 target lesions in 37 target coronary arteries and 48 coronary stents were implanted totally,mean implanted coronary stents were(2.06±0.90)per person.There were 6 patients(26.1%)who received general anesthesia.The operation duration was 72 ~ 157 minute,and the median time is106.5(93.5,138)minute.The dosage of contrast agent was 235 ~338ml,and the median dosage was 279.5(255,304.5)ml.All the combined operations were completed successfully and there were no one associated serious complications or deaths during in the operations.(2)There was not primary clinical endpoint event.And 1 case(4.3%)had secondary clinical endpoint event,asymptomatic ipilateral cerebellar acute lacunar cerebral infarction occurred after vertebral artery stenting.(3)One patient(4.3%)presented with the primary endpoint event within 3 months after the operation,and the patient was discharged after the second operation.(4)Admission modified Rankin Score was 0 in 7 cases,1 in 15 cases and 3 in 1 case.three months after the operation,mRS score was 0 in 18 cases,1 in 4 cases and 2 in 1 case.Conclusion:Simultaneous interventional therapy in treatment of coexistent cerebrovascular stenosis and coronary heart disease is a safe and effective treatment strategy,and clinical effect and short-term prognosis are good,which would provide more options of treatment for patiens in clinical work,who coexistent cerebrovascular stenosis and coronary heartdisease.But any treatment strategy are not perfect,when large randomized clinical studies confimed the combined intervention operation,surgeons should avoid blindness,and reduce the occurrence of adverse clinical events,and need to be careful to choose cases implementing joint surgery.As a result,the future still need to our efforts what bring the patients safe efficacy and concise treatment strategy.