Analysis Of Curative Effect And Associated Risk Factors Of Ischemic Cerebral Vascular Disease After Interventional Therapy

Objective: To diagnosed with ischemic cerebrovascular disease, in line with indications for interventional therapy in patients with follow-up after completion of intervention, observe patients quality of life, and then send the case and related risk factors of vascular events, in order to achieve the prevention of the disease again hair, the purpose of improving the quality of life of patients.Methods:1 General information: Cangzhou People’s Hospital in 2011 January to 2014 February in Department of internal medicine in hospital a total of 40 patients, all patients were consistent with the diagnosis of ischemic cerebrovascular disease standard fourth circle national cerebrovascular disease made at the meeting, USA National Institutes of Health Stroke Scale(NIHSS) score less than 10 points, after a magnetic resonance angiography(magnetic resonance angiography CT angiography, MRA) or(CT-Angiography, CTA) examination revealed large artery stenosis underwent digital subtraction angiography(DSA), using the NASCET method to evaluate the degree of stenosis, in conformity with the Chinese ischemic cerebrovascular disease endovascular interventional treatment guidelines recommend standards: age > 18 years, symptomatic extracranial vascular stenosis 50%, asymptomatic stenosis 70%, signed the informed consent, interventional therapy.2 Treatment methods: preoperative full preparation in local anesthesia drugs, balloon dilation, stent placement, and the careful handling of blood pressure, heart rate changes. Finally, angiography confirmed residual stenosis and distal blood supply. Patients in the neurological department of internal medicine care unit 24 h monitoring, monitoring of vital signs and symptoms and signs of nervous system changes.3 Follow-up: all patients were followed up or visit: on the time of second day after operation, 3 months and 1 year. ①The TCD and carotid color ultrasonography, one year feasible DSA or CTA examination postoperatively understand restenosis and plaque formation. endpoint events were recorded, ②the patient died analyze the possible cause of death, after interventional treatment of new-onset vascular events, including transient ischemic attack(TIA), recurrent infarction, cerebral hemorrhage, subarachnoid hemorrhage(SAH) time, the number of vascular distribution of responsibility. ③record improved RANKIN Scale(mRS), ADL(BI), the US National Institutes of Health Stroke Scale(NIHSS) score to determine the quality of life of patients. ④ control of risk factors, including the risk factors for hypertension, diabetes, hyperlipidemia, smoking, blood homocysteine and other control conditions.Result:1 interventional therapy: 40 patients were treated in 42 stenotic arteries, residual stenosis were less than 20%, the distal blood supply area of blood flow patency; heart rate, low blood pressure occurred in 15 patients, after atropine, dopamine, colloidal solution treatment, returned to normal within 48 hours; 2 cases of patients with postoperative headache, head CT scans with no bleeding, no exception caused by high perfusion, given 1 week after remission within the active control of blood pressure.2 Restenosis after angioplasty: postoperative examination of carotid color ultrasonography, TCD, CTA were found in interventional vascular restenosis at 2, the degree of stenosis were 40% and 30%, no relevant TIA or cerebral infarction, give to strengthen drug treatment, continue to follow up half a year without obvious change of vessel stenosis; interventional vascular restenosis rate of 4.76%.3 Vascular events and end events after interventional treatment: a patient died during 1 years follow-up in 40 patients, 1 cases of cerebral hemorrhage, cerebral infarction in 2 cases, TIA 2 cases 4 times attack. The death of the patient died because of heart disease; cerebral hemorrhage hypertension is poorly controlled, not the law of antihypertensive drugs; 2 cases of cerebral infarction patients with type 2 diabetes, have multiple risk factors of cerebral vascular disease, stroke risk score(ESSEN) up to 6, the responsibility of vascular non intervention treatment of blood vessel. 2 cases of TIA attack patients, ESSEN score were 5 and 6.4 Efficacy: mRS, NIHSS, BI score was no significant change from preoperative to postoperative day 2; after 3 months, 1 year follow-up mRS, NIHSS scores decreased average, BI increase of average. As follows: 1-end point mRS scores were 4 cases of elevated(new vascular event or death), no change, 25 cases of 11 cases of varying degrees of decline, reduce the degree of disability. BI score at one end and a 30-point increase patients improve daily living, quality of life improved significantly, three cases due to decreased stroke events, six cases of no change, and 1 died. NIHSS score at one end point scores dropped 31 cases, no change in 5 cases, 3 cases due to increased stroke, and 1 died. Overall a good degree of neurological recovery.Conclusions:1 Patients have extracranial large artery stenosis with ischemic cerebrovascular disease, interventional therapy is safe and effective, improving the quality of life postoperative follow-up, is an ideal method of treatment.2 Multiple risk factors, type 2 diabetes and poor compliance are important reasons of reduce vascular events after interventional therapy.3 Improve the compliance of patients, effectively controlling cerebrovascular disease risk factors, may reduce the incidence of vascular events after interventional treatment.