Safety And Clinical Efficacy Of Stenting For Intracranial Vertebrobasilar Atherosclerotic Stenosis

Objective:1.To evaluate the safety and complications of stenting therapy of intracranial vertebrobasilar artery stenosis.2.To observe the clinical efficacy of stenting therapy of symptomatic intracranial vertebrobasilar artery stenosis.Methods:106 patients with intracranial vertebrobasilar artery stenting were admitted to the interventional group of Department of Neurology,Second Hospital of Hebei Medical University from January 2015 to March 2018.The clinical symptoms,risk factors related to cerebrovascular disease,imaging data,surgical condition,preoperative and postoperative stenosis rate,perioperative and follow-up complications rate,blood flow velocity,NIHSS score and mRS score at the site of stent implantation before,on the first day,three months,six months and 12 months after operation were recorded,and the data changes before and after operation were compared and analyzed by SPSS software.Results:Among 106 patients,77 were males and 29 were females,aged from 40 to 77 years,with an average age of 63.43 ± 7.58 years.105 stents were successfully implanted with a technical success rate of 99%(105/106).A total of 126 stents were implanted,including 8 carotid artery stents,4 subclavian artery stents and 9 vertebral artery stents.Stenosis decreased from(81.41±10.12)% before operation to(9.31±7.34)% after operation.The improvement of stenosis rate was statistically significant.The incidence of perioperative complications was 4.7%(5/106),including 1 case of subacute thrombosis in stent,2 cases of perforator artery occlusion,1 case of hyperperfusion 2 hours after operation and 1 case of cerebellar hemorrhage 3 days after operation.During one-year follow-up,14 cases of restenosis were found,in which symptomatic restenosis was 5.4%(4/74),and the recurrence rate of stroke in vertebrobasilar artery blood supply area was 5.4%(4/74).During the follow-up period,1 case died of traumatic cerebral hemorrhage.At the last follow-up,86.8%(92/106)patients had a mRS score less than 2.Conclusion:Cerebrovascular stenting for symptomatic intracranial vertebrobasilar artery stenosis has high safety,high success rate,marked improvement of stenosis,low incidence of perioperative complications,low incidence of symptomatic restenosis during follow-up,and low recurrence rate of stroke during follow-up compared with drug treatment.Cerebrovascular stenting for symptomatic intracranial vertebrobasilar artery stenosis is feasible,safe and effective.