The Control Strategy Of The Complications Of The Stent-angioplasty For Symptomatic Intracranial Atherosclerotic Stenosis

ObjectiveTo investigate the complications of symptomatic intracranial atherosclerotic stenosis stenting by observing the adverse events and In-stent restenosis and probe into the methods of their prevention and management.Methods1.Of the 68 cases of patients with intracranial artery stenosis were selected and divided into treatment group 31 cases and control group 37 cases,two groups of patients,age,gender,comorbidity,intracranial artery stenosis,TCD peak velocity,and neural function score analysis,were not statistically significant.2.The mean artery stenosis rate(82.4+11.3%)and the average length of the stricture(7.2+3.2)mm were obtained by DSA evaluation and the patients were divided into type A20,type B 7,type C 4 According to Mori.3.It be analyzed for the characteristics of sICAS history,imaging findings,vascular stenosis state of the pateints and it be summed for the technical essentials,indications and contraindications of the intracranial stent-angioplasty(IASA).4.25 patients treated with Apollo-stent and 6 cases with wingspan stent angioplasty;The dual anti-platelet therapy of asprin(300mg every day,1 times a day)and Clopidogrel(75mg every day,1 times a day).The clopidogrel stopped after 3months,aspirin instead of 100mg/day after 12 months,and aspirin taken a lifetime.5.According to different underlying diseases,the patients were treated with anti-platelet aggregation drugs,hypolipidemia drugs,hypotensor and hypogitcemic agent to control the risk factors.6.Clinical follow-up was taken 1 times every 3 months,and the periods vary from 6 to36 months,with an average of 17.6 months.Detailed records: complications,NIHSS scores,restenosis.The Imaging examinations included TCD,MRA,and DSA.If TCD artery peak velocity reached to the preoperative state or significantly increased,or In-stentrestenosis(ISR)is suspected by MRA,DSA was taken for ICAS diagnosis.ISR can be determined by the degree of vascular stenosis rate over 50%.Results1.Technical success rate was 100% in 31 cases,with one case died due to severe low blood pressure and large area cerebral infarction after operation,other case of excessive perfusion syndrome,last case with cerebral infarction occurred 6 days after the operation and recovered from interventional thrombolysis.The incidence of perioperative complications was 9.6% and the perioperative mortality was 3.2%.There are 6 patients with of the In-stent Restenosis(ISR)in the follow-up period,who all have diabetes.The ISR rate is 20.0%,5 cases without symptom,and 1 case of mild stroke recovered after treatment,the total stroke rate is 6.7%?2.The 10 cases(27%)in the control group were stroke(P < 0.05),the treatment group and the control group NIHSS final scores were(7.7±6.4)and(14.2 + 5.1),there was significant difference between two groups(P < 0.05),and the quality of life of patients in the treatment group is better than control group.Conclusion1.The stent angioplasty in the treatment of intracranial arterial stenosis and proventation of ischemic stroke is effective.2.The intracranial artery stent angioplasty is still a lot of potential complications,needing to monitor and take measures.