| Objective: Objective to investigate the short-term and long-term efficacy of vertebral artery stenting for the treatment of atherosclerotic vertebral artery stenosis and its significance in prevention and treatment of ischemia cerebrovascular disease.Methods: 69 cases were collected according to the inclusion criteria,who had symptomatic vertebral artery stenosis(?50%)during the period from January 2013 to December 2016 in Ruikang Hospitial Affiliated to Guangxi University of Chinese Medicine.These cases were divided into stent group and drug group,according to treatment.Stent group included in 32 cases,Drug group included in 37 cases.Age between 52-75 years old.All patients were evaluated with CE-MRA or CTA or DSA.The degree of vascular stenosis was assessed with the North American Symptomatic Carotid Endarterectomy Trial.The treatment group was treated with Guidelines for the secondary prevention of ischemic stroke and transient ischemic attack in China.The stent group was treated with stent surgery on the basis of drug therapy.To observe the clinical symptoms(dizziness,limb paralysis,balance disorder,etc.),the general data of the two groups.CE-MRA,CTA,DSA were used to observe the changes of vascular stenosis in patients.To observe the changes of the patients before and after the stent implantation,the perioperative complications.During the follow-up,the stent group had 2 cases,drug group had 1 case,were excluded from the study due to the failure of treatment according to the provisions of the program.The remaining stent group 30 cases,drug group 36 cases completed follow-up,the mean follow-up period was 19.3±5.6 months.Results: There was no significant difference between the two groups in age,gender,hypertension,diabetes,hyperlipidemia,coronary atherosclerotic heart disease,smoking history,and the degree of stenosis of the vertebral artery(P>0.05).There was comparability between the two groups.Stents were successfully implanted in 30 patients.A total of 31 balloon expandable stents were implanted.The success rate of stenting was 96.77%.After stenting,the degree of stenosis of stent group decreased from 76.37±10.06% to 7.63±4.41%.The degree of vascular stenosis was significantly improved.After operation,the development of the distal branches of the vessels were significantly increased.The degree of vascular stenosis before and after operation was statistically significant(P<0.05).Perioperative complications occurred in 2 cases(6.45%)in stent group within 30 days.1 case appeared retroperitoneal hematoma hemorrhagic shock,1 case appeared cerebral vasospasm during the surgery.Two groups of patients with clinical symptoms(dizziness,limb paralysis,balance disorders,etc.)remission rate,the difference was statistically significant(P < 0.05)at the 30 days,6 months.After 12 months of follow-up,the incidence of TIA of two groups was compared,the difference was statistically significant(P < 0.05).Two groups of patients with the average rate of vascular stenosis were compared,the difference was statistically significant(P < 0.05).The clinical symptoms remission rate of the two groups were compared at 12 months,24 months,the difference was not statistically significant(P > 0.05).There was no significant difference in the incidence of TIA between the two groups at the follow-up of 30 days,6 months,24 months.The incidence of cerebral infarction in the two groups was compared at 30 days,6 months,12 months,and 24 months,the incidence of cerebral infarction in stent group was less,but the difference was not statistically significant(P > 0.05).Conclusion:The vertebral artery stenting can improve the clinical symptoms of the patients in the short term.Vertebral artery stenting may reduce the incidence rate of TIA after operation within a year.Vertebral artery stenting and drug treatment had no differences in the prevention of cerebral infarction within 2 years later.Further research is still needed to prove the preventive effect of vertebral artery stenting for ischemic cerebrovascular disease. |
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