Efficacy Observation Of Endovascular Stenting For Cervical Arterial Dissection

Objective: to evaluate the endovascular carotid stenting clinical curative effect for the treatment of cervical artery dissection.Methods: retrospective analysis of 53 cases of the extra-cranial NIHSS score ≥ 1 in the Second Affiliated Hospital of Chongqing Medical University,Xinqiao Hospital affiliated to the Army Military Medical University,the Fifth People’s Hospital of Chongqing,and the Three Gorges Central Hospital of Wanzhou District,Chongqing City.Clinical data of patients with segmental cervical artery dissection arterial disease,according to their follow-up NIHSS and mRS scores to evaluate the safety and effectiveness of surgery.Results: Of the 53 patients,24 underwent endovascular stenting and 29 underwent conservative medical therapy.The follow-up time of the operation group and the non-surgery group were 6 months to 5 years,3 months to 5 years,respectively.There were no surgery-related deaths in 24 CAD patients,and 3 patients had transient bradycardia and chest pain.After symptomatic treatment,the success rate was 100%.At the end of follow-up,the mean mRS scores of the 21 patients in the surgical group were(1.05±1.16),which was significantly different from the preoperative mRS score(P=0.03).The patients with mRs ≤ 2 in the surgical and non-surgical groups were 17 respectively.In the case(71%)and 8 cases(28%),the surgery group improved significantly.The patients in the operation group and the non-surgery group were divided into three subgroups: NIHSS ≤ 4 points,> 4 points,≤ 10 groups,and > 10 groups.The patients underwent NIHSS ≤ 4 grouping.The mRS scores at follow-up and admission were respectively.The scores were statistically significant(P=0.003).The non-surgical patients had NIHSS≤4 grouping.The mRS scores at follow-up and admission were 2.44 and 2.11,respectively.The difference was not statistically significant(P=0.282).).In the NIHSS score ≤ 4 group,the mean improvement scores of mRS scores in the surgery group and the non-surgery group were 1.71 points and 0.33 points,respectively,and the difference was statistically significant(P=0.009).The mRS score of the operation group was significantly better than that of the non-surgery group.group.In the NIHSS score > 4 points and ≤ 10,the mean improvement in mRS scores in the surgical and non-surgical groups was 3.57 points and 0.91 points,the difference was statistically significant(P = 0.000),and the NIHSS score > 10 points for surgery and non-surgery.The mean improvement of mRS scores in the patients was 1.86 and 1.43,and the difference was not statistically significant(P=0.361).At the end of follow-up,all surgical and non-surgical patients did not have TIA,stroke,or death.Conclusion:The endovascular extracranial carotid stenting of cervical artery dissection is effective and safe.