| Background: Stroke is a common disease in China at this stage.It has three characteristics: high morbidity,high morbidity,and high mortality.Studies have shown that stroke has ranked first in the cause of death in our country.Stroke can be caused by many factors,among which intracranial artery stenosis caused by atherosclerosis is the most common.The treatment of intracranial atherosclerotic stenosis consists mainly of medical treatment and intravascular stenting.Stent placement and enhanced medical treatment to prevent intracranial arterial stenosis recurrent stroke(SAMMPRIS)because of excessive stroke relapse rate and mortality was prematurely terminated within 30 days,the test results show: Wingspan self-expanding stent system does not Better than medical treatment.The Vitesse intracranial stent therapy for ischemic stroke study(VISSIT)showed that the incidence of any stroke or transient ischemic attack within 30 days and high incidence of intracerebral hemorrhage within 30 days in the stent-treated group did not support the ball.Expanded bracket use.These studies all suggest that endovascular stenting will not benefit either in terms of efficacy or safety compared to medical treatment.Considering thatthere are some controversies involved in participating in the SAMPRIS test,for example,most of the participating pilots are small centers,and the average annual surgery volume is small.There may be situations in which the surgeon's operation proficiency and experience are insufficient,and whether the test results are applicable to Asian populations.The purpose of this study was to investigate the effective and safe clinical treatment of severe atherosclerotic stenosis patients treated in the Department of Neurology,First Affiliated Hospital of Guangxi Medical University.Method: From October 2016 to April 2017,66 consecutive cases of major intracranial arteries(including the intracranial segment of the internal carotid artery and middle cerebral artery segment M1)were hospitalized in the Department of Neurology of the First Affiliated Hospital of Guangxi Medical University.The patients with atherosclerosis and severe stenosis(stenosis rate >70%)in patients with vertebral artery V4 and basilar arteries had the advantages and disadvantages of medical treatment and stenting prior to treatment and communicated well with patients and their families,according to the individual wishes of the patient.The choice of patient's vascular condition is to adopt medical treatment or stenting therapy.In patients with stenting therapy,informed consent must be signed before surgery.The patient was followed up until April 2018.The primary end point of the subject was any form of stroke and death within 30 days;the secondary end point was any type of stroke and death of the same side of the vessel within one year;at the same time,the image was examined after 1 year of treatment(whole brain Angiography,CTA,or MRA was used to compare the changes in vascular stenosis between the medical treatmentt group and the stenting group,and to judge whether there was any change in neurological function between the two groups by NIHHS score andmRS score.Result: The primary end point occurred in 2 patients in the medical treatment group,2 strokes occurred in each patient,and 2 primary stenting events occurred in the stenting group.The incidence of the primary endpoint was 4.77% and 8.33%,respectively.Differences in learning(P>0.05).At the1-year follow-up,14 patients in the medical treatment group had a secondary end point event,and 2 patients in the stent treatment group had a secondary end point event.The incidence of secondary end point events was 33.3% and8.33%%,respectively.Difference(P<0.05).Conclusion: There was no significant difference in the incidence of stroke and mortality in the short-term(30-day)patients compared with medical-only treatment compared with medical-only treatment;medical treatment plus stenting was used to prevent stroke during follow-up to 1 year And death is better than simple medical treatment. |
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