The Study Of TCM Syndrome And The Curative Effect Of Endovascular Stent-assisted Angioplasty For The Patients With Ischemic Cerebrovascular Disease

ObjectiveTo study the clinical effectiveness, safety of endovascular stent-assisted angioplasty for the cerebral artery of patients with Ischemic cerebrovascular disease and the relationship with the types of syndromes of TCM. MethodsThe dates of228patients with Ischemic cerebrovascular disease are retrospective analyzed. The patients are all treated in Guangdong provincial hospital of Chinese medicine by using endovascular stent-assisted angioplasty. Collecting the patients’information of endovascular stent-assisted angioplasty, complication and the types of syndromes of TCM.127patients are followed up. We collect the information of the happening of vascular events and in-stent restenosis. ResultsThere are228patients and290vascular stenosises including139are in carotid artery system,151are in vertebral artery system,87are intracranial arteries and204are extracranial arteries.289vascular stenosises are treated by endovascular stent-assisted angioplasty.111cases are used balloon-expandable stent and178cases are used by self-expandable stent. The residual stenosis of all arteries are≤40%.29patients have complication during perioperative period,11cases of cerebral infarction,6case of cerebal hemorrhage,4cases of cerebral infarction and cerebal hemorrhage,4cases of heart rate and blood pressure falling,1case of angiospasm but no cerebal hemorrhage,1case of pseudoaneurysm, lcase of arterial thrombus in lower limbs.2patients die during perioperative period. We follow up127patients for a period of3-36months.26patients have vascular events including TIA, recurrent stroke, cerebal hemorrhage and cardiovascular events.19patients have in-stent restenosis. No patients die during the follow-up period.10types of syndromes of TCM are diagnosis among the228patients."Wind-phlegm and blood stasis in collaterals" rank first, followed by "the wind phlegm interference with blood stasis","wing-fire-phlegm and blood stasis in collaterals","Liver-yang hyperactivity, wind and Fire disturbance","Qi deficiency, phlegm and blood stasis in collaterals","blood stasis due to qi deficiency","phlegm-heat accumulation, wind phlegm interference","wind formation from yin deficiency","phlegm dampness syndrome by the mind","liver-yang hyperactivity, phlegm blocking orifices". The phlegm syndrome, stagnation of blood, wind syndrome, syndrome of deficiency of Qi and syndrome of fire-heat are the main syndrome. The types of syndrome were mainly combined of three syndromes, followed by the combination of two and four syndromes. But the combinations of five syndromes or single syndrome are rare.To study the connection between the top four types of syndromes and the degree of the vascular stenosis, the position of the vessel and in-stent restenosis, we do statistic analysis. The results show us that there are no connections between the types of syndromes, the degree of the vascular stenosis and in-stent restenosis. The types of syndromes of intracranial arteries and extracranial arteries are the same. But the types of syndromes of carotid artery system are different with vertebral artery system. ConelusionEndovascular stent-assisted angioplasty is a safe and effective treatment for cerebral arterial stenosis."Wind-phlegm and blood stasis in collaterals" is the main type of syndrome for patients with Ischemic cerebrovascular disease. The difference of the syndrome of TCM has no relationship with the degree of the vascular stenosis and in-stent restenosis. And the types of syndromes of intracranial arteries and extracranial arteries are the same. But the difference of the syndrome of TCM is due to the difference of carotid artery system and vertebral artery system.