Intracranial Atherosclerotic Stenosis Or Occlusion With EC-IC Bypass Therapy

Objective:To assess the application value of intracranial-extracranial(EC-IC)bypass treatment for intracranial large atherosclerotic stenosis or occlusion.Method:Fifty-four patients undergone STA-MCA bypass surgery in Department of Neurosurgery of the First Affiliated Hospital of Nanchang University,from January2010 to June 2015 were enrolled in this study,with their imaging findings suggest unilateral intracranial atherosclerotic stenosis or occlusion and heamodynamic impairment.In the way of outpatient,hospitalized,or telephone.All patients were follow up for two years.Moddified Rankin scale(mRS)and NIH Stroke Scale(NIHSS)was used to evaluate the neurologic function of the patients at preoperative,1week,3 months and 2 years after the treatment.collected data were analyzed by statistical software SPSS 17.0.At the same time,the results of this study were compared with the relevant literature at domestic and abroad to prove the effectiveness in patients with intracranial atherosclerotic stenosis or occlusion with heamodynamic impairment.Result:A total of 54 patients with intracranial atherosclerotic stenosis or occlusion.Including 42 cases of patients who met the Inclusion criteria,all performed unilateral superficial temporal artery-mid middle cerebral artery bypass(STA-MCA);There were25 men and 17 women in an age range of 32 to 66 years(mean51.2 years)and a follow-up range of 24 to 86 months(mean40 months);7 days after surgery,DSA or CTA was reviewed.Forty-nine patients(95%)had anastomotic patency.The 2 years risk of stroke was 7.5% after surgery,And the stroke recurrence rate was 4.8%(2/42)at 1 week after surgery,and 2.7%(1/37)were newly added during the follow-up period of 2 years.The NIHSS scores of 3 months and 2 years after operationdecreased(Z=-2.449,-3.240 P<0.05);The mRS scores of 3 months and 2 years after operation decreased(Z=-3.000,-4.041 P<0.05).Conclusion:1)STA-MCA bypass surgery can reduce stroke recurrence in patients with intracranial atherosclerotic stenosis or occlusion with heamodynamic impairment.2)STA-MCA bypass surgery has a significant effect on the long-term neurological function of patients.