Evaluation Of Drug And Stent In The Treatment Of Stroke Recurrence Regarding Patients With Intracranial And Extracranial Artery Stenosis

Objective: To explore the difference of intracranial and extracranial severe artery stenosis in patients with drug treatment and endovascular stenting in the treatment of recurrent stroke of Hebei Cangzhou area, regarding patients with intracranial and extracranial artery stenosis, in Hebei Cangzhou area, In order to find of this kind of patients the best treatment method suitable for area differences.Methods:1 the selection of research object 2007 June to 2013 June, we selected 800 cases of intracranial and extracranial artery stenosis(70-99%) patients as the research object in Hebei province Cangzhou city people’s Hospital, are consistent with the standard of the fourth national cerebrovascular disease academic meeting. Divided into drug treatment group and stent implantation group, the difference in risk factors for cerebrovascular disease on gender, age, hypertension, hyperlipidemia, smoking history, diabetes and so on, was not statistically significant。2 treatment method ①The drug treatment group: In accordance with the guidelines of two grade prevention of ischemic stroke, the active control of risk factors in patients, application of lipid-lowering drugs atorvastatin calcium 20 mg, given aspirin 100mg/d, Clopidogrel Hydrogen Sulfate 75mg/d; double anti union application after March, changed to aspirin 100mg/d.②The stent implantation group: According to the right artery stent implantation operation method, release the support success, the standard of a successful release: residual stenosis rate <30%, forward flow well. The stenosis in excess of 30% patients need again balloon, in general anesthesia patients awake after, check again nervous system function test; aplication of drug therapy after operation: given aspirin 100mg/d, Clopidogrel Hydrogen Sulfate 75mg/d; double anti union application after 3 months, instead of aspirin 100mg/d long-term use. Observation method: The patient was discharged after first years, second years, head, neck CTA or DSA review, narrow vascular situation consideration, wardrobe MRI consideration, the existence of new stroke, recording the criminal vascular occlusion, restenosis and TIA, cerebral infarction, application of NIHSS were assessed by integrated neural system.Results: For the case of recurrence and restenosis compared, During a follow-up period of 1 years,drug group new stroke incidence rate was 23.08%, the narrow vascular stroke incidence rate was 18.9%, the mortality rate was 5.7%, stent group new stroke incidence rate was 17.0%, the narrow vascular stroke incidence rate was 4.3%, the mortality rate was 4.91%. The difference was statistically significant(P<0.05); During a follow-up period of 2 years,drug group new stroke incidence rate was 38.1%, the narrow vascular stroke incidence rate was 30.44%, the mortality rate was 8.65%, stent group new stroke incidence rate was 26.6%, the narrow vascular stroke incidence rate was 14.95%, the mortality rate was 4.91%. The difference was statistically significant(P<0.05)Conclusion: In view of severe intracranial and extracranial artery stenosis, in patients discharged from hospital after 1 years, 2 years of follow-up, endovascular stent implantation in new ischemic cerebrovascular disease incidence, mortality, average NIHSS score after statistical treatment was better than drug treatment group.In high salt diet area, in the treatment of severe intracranial and extracranial artery stenosis patients, the treatment of endovascular stenting is effective in preventing the recurrence of cerebral vascular disease.