Study On The Correlation Between Collateral Circulation Of Symptomatic Vertebral Artery Stenosis And The Effect Of Endovascular Stenting

Objective: To analyze and evaluate the effects of collateral circulation on stent implantation in patients with symptomatic vertebral artery stenosis.Methods: 130 patients with symptomatic severe stenosis at the beginning of vertebral artery and stent implantation in the First Affiliated Hospital of Xinjiang Medical University from January2013 to December 2017 were divided into two groups: good collateral circulation group(60 cases)and bad collateral circulation group(70 cases).All patients were registered for age,sex,blood pressure,diabetes mellitus,low density lipoprotein,high density lipoprotein,smoking and drinking history.NIHSS score and ADL score at admission were recorded,and the perioperative complications,recurrence rate of cerebral infarction,mortality and neurological function(NIHSS score),quality of life(ADL score),clinical efficacy and in-stent restenosis were compared between the two groups before and after treatment.Data differences between the two groups were analyzed by t-test and chi-square test.Results: 130 stents were successfully implanted in 130 patients,with a success rate of100%.60 patients in the group with good collateral circulation and 70 patients in the group with poor collateral circulation were in the group with good collateral circulation,and the recurrence rate of ischemic stroke was low in the group with good collateral circulation.NIHSS score was lower and ADL score was higher in the group with good collateral circulation(P < 0.05).There were no significant differences in age,sex,diabetes,LDL,smoking and drinking history between the two groups(P > 0.05),hypertension and HDL(P < 0.05).In-stent restenosis may be related to residual stenosis greater than 20%,subclavian artery length less than l mm,diabetes mellitus and smoking(P < 0.05).Fine operation during operation,reducing residual stenosis,strict standard medication after operation,controlling blood sugar,quitting smoking and so on are beneficial to reducing restenosis.Conclusion: 1.The group with good collateral circulation had low perioperative complications,good curative effect and lower recurrence rate of cerebral infarction;2.High density lipoprotein(HDL)and mild hypertension were well correlated with collateral compensation;3.Symptomatic VAOS,with high success rate and low complications,was a safe and effective method of diagnosis and treatment;4.The restenosis rate after stent implantation at the beginning of vertebral artery was high and the intraoperative precision was high.Fine operation,reducing residual stenosis,taking medicine strictly after operation and controlling blood lipid and blood sugar are beneficial to reducing restenosis.