Discussion About Treatments In Patients With Various Degree Of Vertebral Artery Origin Stenosis

Background and Objectives:With the development of the society as well as the increasingly serious problems of aging,vascular of coronary and cerebral disease has become one of the highest lethality disease worldwide.Chronic ischemic cerebrovascular disease shows the higher frequency among them.Frankly,the internal carotid artery,vertebral artery,middle cerebral artery and basilar artery are more possible to undergo atherosclerosis and bring corresponding cerebral infarction symptoms due to their luminal stenosis.This article is aim to compare the effectiveness between stents placement combined with drugs and drugs only in patients with over 50%stenosis in vertebral artery original segment.And in order to compare the efficiency between patients with or without over 50%stenosis in VAO suffered from post cerebral circulation ischemic attack under solitary medicine treatments.Materials and MethodsThe clinical data of 62 patients with post cerebral circulation TIA or stroke from September of 2015 to December of 2016 were analyzed retrospectively,and then classified into two groups according to their radiology imaging results.Group A contained 20 patients with less than 50%of vertebral artery origin stenosis(VAOS).Group B incorporated 42 patients with more than 50%in VAOS.Besides,according to their remedies,group B was classified into sub-group B1,containing 16 patients,which were treated by regular and congruent drugs and B2,including 26 patients,which were underwent stent placement to stenosis part of vertebral artery combined with drugs.Comparison was made in four aspects.First of all,modified Rankin Scale score(mRS score)was utilized as the criteria of neurological improvements.Moreover,reoccurrence rates of TIA or homolateral stroke,incidence in severe stroke and post-stenting stenosis were then estimated between three groups and the period for follow up was at least one year.Results62 patients suffered from post circulation ischemia syndromes were categorized into three groups according to the radiology imaging and therapies.Among them,20 patients were diagnosed with slight VAOS(less than 50%)and 42 patients were more than 50%.16 of them were treated with regular medicines while 26 of them were cured by stent implantation as well as corresponding drugs.Three groups of patients had no statistical significances in age(P=0.918),hypertension(P=0.193)and diabetes mellitus(P=0.693).Besides,in terms of blood fat,patients of three groups showed no significant differences in low density lipoprotein cholesterol(L-LDL)and Triglyceride(TC)(P>0.05).also,for the patients with severe VAOS(more than 50%),incidence of post circulation ischemic stroke were higher in patients combined with anterior circulation stenosis,p=0,038<0.05,group B1 were more likely to have higher incidence in stroke(11/16 vs 4/20;68.75%vs 20%,P=0.004<0.05)as well as mRS score(1.625VS0.15)equally compared with group A.And even more frequency in severe brain infarction,,P=0.046<0.05.Also,group B2 were easily to be found with lower proportion of reoccurrence in stroke(1/26;3.84%vs 3/16,18.75%,P=0.001<0.05)and mRS score(0.75VS1.625)respectively.Incidence of post-stenting stenosis was accepted in an appropriate scope(5/26,19.23%).ConclusionsDrugs only are more suitable to patients with less than 50%VAOS.Besides,for more than 50%VAOS patients,stenting combined with drugs seem to be better.