Stenting Versus Medical Care For Intracranial Arterial Stenosis

Background and PurposeFrom a long time people have only paid attention to the treatment of cerebrovascular disease. In recent years, along with the evolution of new idea and the advancement of technology, people have focussed attention gradually on the prevention of cerebrovascular disease and intracranial artery narrow,which is one of the important causes of ischemic stroke. Numerous studies have demonstrated that the treatment of intracranial artery stenosis can effectively prevent ischemic stroke caused by intracranial artery stenosis and reduce the mortality, so the treatment of intracranial arterial stenosis becomes the research focus. Along with the deeper studies and technical updates, the treatments of intracranial artery stenosis is unceasingly enriched and updated and especially the appearance of intravascular stent angioplasty has challenged the traditional medical treatment. A lot of research is committed to the contrast studies, but at present the pre and post medication of stent angioplasty for intracranial arterial stenosis has not reached the consensus of opinion completely. The pupose of this study is to compare endo vascular stents before angioplasty Not rule and gauge medical treatment and simple medical treatment for intracranial moving The curative effect of narrow vein. MethodsRetrospective analysis of a total of70cases of the intracranial artery stenosis patients between January2010and March2011in Zhengzhou university first affiliated hospital, which included21preoperative law cases of the medical treatment and18irregularly law cases. Another31cases adopted with normal medical treatment. All cases were followed up for1year, and the detailed records (1) after30d the United States national institutes of health stroke scale (NIHSS) scores rating:reduce>50%person think it has good effect, or less50%person think it has poor effect;(2) within30days after transient ischemic attack (TIA), stroke incidence and mortality;(3) after one years transient ischemic attack (TIA), stroke incidence and mortality;(4) MRS score to MRS two points for the quality of life is high, more than three points and poor quality for survival.ResultsRecently after the operation (30d) NIHSS evaluated that the regular drug users who had good effects occupied19/21(90.5%), the ones in poor effects was2/21(9.5%), the irregular drug users who had good effects occupied14/18(77.8%), the ones in poor effects was4/18(22.2%). The regular drug users had better effects than those who didn’t take drug regularly recently (P<0.01).And in comparison with the patients of stent angioplasty, the patients of pure surgery had a low incidence of stroke within30days. After2～3years follow-up,5(27.8%) irregular drug users of Stent angioplasty died, however only one of the regular drug users died.(4.8%) had strokes, and simple medical treatment of those2cases (6.4%) had strokes or death. And before stent angioplasty not rule the medical treatment comparison, preoperative rule the medical treatment and the simple medical treatment postoperative1year stroke incidence and mortality are reducing (P<0.005).MRS score is prompt stent angioplasty befor the pharmaceuticals law and the simple medical treatment survival quality is better than no postoperative pharmaceuticals law (P<0.005) ConclusionsThe intracranial artery stenosis stent angioplasty in patients with preoperative rule medical treatment and simple medical treatment to reduce intracranial artery stenosis in patients with stroke incidence and mortality and improve the patients’ quality of life, support angioplasty perioperative stroke incidence is higher than pure medical treatment.