Etiology Of Carotid Stenting For Symptomatic Cerebral Infarction

[Objective] To summarize and analyze the cause of symptomatic cerebral infarction caused by carotid stenting.【Methods】 Analysis cases of January 2005 to January 2016 who took carotid artery stenting and symptomatic cerebral infarction occured from department of neurology,the first affiliated hospital of Guangxi Medical University.Evaluating the incidence of symptomatic cerebral infarction by reviewing the newly diagnosed cerebral infarction and related cardiovascular vessels by postoperative review of cerebrovascular angiography and imaging examination.Reviewing the preoperative preparation of the carotid artery stenting,procedure and analysing the causes of symptomatic cerebral infarction【Results】 From January 2005 to January 2016,a total of 931 patients underwent carotid artery stenting,including 23 cases of symptomatic cerebral infarction,accounting for 2.47% of all patients with carotid artery stenting.According to the responsibility of blood vessels,divided into:(1)middle cerebral artery blood supply-related cerebral infarction: 20 cases;(2)anterior cerebral artery blood supply-related cerebral infarction: 2 cases;(3)basilar artery blood supply-related cerebral infarction.The 23 cases of symptomatic cerebral infarction causes:(1)intravascular instability plaque shedding,ulceration in 9 cases;(2)improper operation in 8 cases(3)anti-platelet drug deficiency or anti-platelet drug resistance in 3 cases;(4)blood vessels during surgery Spasm in 2 cases;(5)unknown cause in 1 case.[Conclusion] Symptomatic cerebral infarction is one of the complications of CAS.The most common cause of SCI in CAS is that the intravascular instability plaque shedding and ulceration,followed by improper operation operation,anti-platelet drug deficiency or anti-platelet drug resistance,cerebral vasospasm.And some are unexplained.On the CAS patients,active preoperative assessment,careful operation and standardized medication are important in reducing the incidence of SCI.