Hemodynamic Changes Of Vertebral Artery Hypoplasia And Its Correlation With Posterior Circulation Ischemic Stroke

Objective: Investigate patients with vertebral artery hypoplasia(VAH),observe the difference in internal diameter and the changes of hemodynamic parameters of intracranial and external vascular vessels,and compare the differences of related indicators compared with the control group after further analysis,and further To study the correlation between the internal diameter difference of these patients and the incidence of posterior circulation ischemia stroke(PCIS),to provide data and reference for clinical prevention and diagnosis and treatment.Methods: A retrospective analysis of 160 patients in clinical neurology was divided into vertebral artery hypoplasia group(observation group)and 80 vertebral artery hypoplasia group(control group)according to the diagnostic criteria of ultrasound vertebral artery hypoplasia.Observe and compare the basic data of patients,including age,gender,and other conditions such as diabetes,hypertension,hyperhomocysteinemia,hyperlipidemia,and coronary heart disease.A vascular high-frequency ultrasound probe and transcranial Doppler were used to explore the intervertebral and intracranial vertebral arteries to obtain relevant detection indicators needed for the study: Vertebral artery diameter(VAD),bilateral Peak systolic velocity(PSV)of intervertebral segment and intracranial segment of lateral vertebral artery,end diastolic velocity(EDV)of bilateral vertebral artery and intracranial segment,and mean intracranial blood flow Velocity(MV),blood flow resistance index(RI)of the intervertebral segment and intracranial segment of bilateral vertebral arteries,and related observation parameters obtained after calculation: bilateral vertebral artery inner diameter difference,bilateral vertebral artery inner diameter asymmetry ratio,bilateral vertebrae The difference in peak flow velocity between the intervertebral and intracranial segments of arteries,the difference in resistance index between the intervertebral and intracranial segments of bilateral vertebral arteries,and the blood flow asymmetry index(AI)of the intracranial segment of bilateral vertebral arteries.And collect other relevant image data of patients.The changes of the corresponding hemodynamic parameters between the two groups were compared,and the correlation between the difference in the inner diameter of bilateral vertebral arteries and the incidence of posterior circulation ischemic stroke in patients with vertebral artery hypoplasia was studied.Incompleteness has an Odds ratio(OR)and a relative risk(RR)of posterior circulation ischemic stroke.Results(1)General information: There were no statistically significant differences in the distribution of risk factors for cerebrovascular diseases such as age,gender,diabetes,hyperlipidemia,hypertension,hyperhomocysteinemia,coronary heart disease,etc.(P> 0.05)).(2)There were 80 cases of vertebral artery dysplasia,among which 46 cases occurred on the right side,57.5%,26 cases on the left side,32.5%,and 8 cases on both sides,10%.(3)In the vertebral artery hypoplasia group,the bilateral vertebral artery inner diameter difference and bilateral asymmetry ratio were significantly higher than those in the control group without vertebral artery hypoplasia,and the differences were statistically significant(P <0.05).(4)The vertebral artery hypoplasia group patients with intracranial and outer cranial systolic peak flow velocity difference,blood flow resistance index value and bilateral RI difference were significantly higher than the control group,the differences were statistically significant(P <0.05);The bilateral intracranial blood flow asymmetry index(AI)values in the VAH group were significantly higher than those in the control group,and the difference was statistically significant(P <0.05).(5)Lateral cerebral ischemic stroke in 38 cases of vertebral artery hypoplasia group,with an incidence of 47.5%;16 cases of posterior circulation ischemic stroke in the control group,with an incidence rate of 20.0%;The incidence of ischemic stroke was significantly higher than that in the control group without vertebral artery hypoplasia,and the difference between the two groups was statistically significant(P <0.05).(6)Correlation analysis between bilateral vertebral artery internal diameter(VAD)difference,bilateral internal diameter asymmetry ratio,and incidence of posterior circulation ischemic stroke between the two groups.There is obvious correlation between them,and there is a positive correlation.(7)Analyze the correlation between vertebral artery dysplasia and posterior circulation ischemic stroke,and its odds ratio(OR)and relative risk(RR).Conclusions(1)Vertebral artery hypoplasia can be identified as an independent risk factor for posterior circulation ischemic stroke.(2)Vertebral artery hypoplasia can significantly change the hemodynamics of the posterior circulation.(3)The more significant the difference in the internal diameter of bilateral vertebral arteries in patients with vertebral artery hypoplasia,the higher the correlation with the incidence of post-ischemic stroke.(4)Therefore,from the perspective of prevention of ischemic stroke,patients should be strengthened in the early screening of vertebral arterial dysplasia in the clinic,and the relevant cerebrovascular disease risk factors should be actively controlled as early as possible,and clinical intervention should be given to high-risk groups to reduce Cerebral ischemia events occur to maximize the protection of people’s health.