Clinical Comparative Study Of Primary Balloon Angioplasty And Stenting For Intracranial Arterial Stenosis

Objective:To compare the feasibility, safety and short-term prognosis ofprimary balloon angioplasty and balloon-expandable stenting and theself-expandable stenting in the treatment of intracranial stenosis.Materials and methods:A retrospective analysis from January2011to January2014include110patients with intracranial atherosclerotic severe stenosis orocclusion and received endovascular treatment in our department.Thepatients were divided into three groups according to the surgicalapproach:the primary balloon angioplasty group, the balloon-expandablestenting group and the self-expandable stenting group, compared thesuccess rate of surgery, before and after treatment lesion stenosis ratechanges, the incidence of perioperative complications and follow-up at3months and12months prognosis. Also, explore Mori vascularclassification, and other factors before and after intracranial arterialcirculation interventional surgical success rate, perioperativecomplication rate, restenosis and other effects. Results:The primary balloon angioplasty group had32patients, the balloon-expandable stenting group had30patients, the self-expandable stentinggroup had48patients, three groups of surgical success rate of93.8%,96.7%and91.7%, preoperative arteries stenosis were91.6%±7.6%,79.7%±7.5%and85.4%±7.1%, postoperative residual stenosis lesionrates were43.7%±16.8%,11.9%±9.6%and29.5%±12.3%,perioperative complication rate were3.1%,6.7%and8.3%, respectively.Mori A-type, Mori B-type and Mori C-type surgical success rates were100%,97.8%and81.8%, perioperative complication rate were3.1%,4.4%and12.1%, respectively. The perioperative complication rate ofMCA/BA group (13.0%) was higher than ICA/VA group(1.7%). Theproportion of good prognosis of the surgical group12months after surgerywere89.3％,88.0％and90.7％.Conclusions:There is no significant difference in terms of feasibility and safetybetween primary balloon angioplasty and stenting, but in the treatment ofpatients with complex intracranial lesions, there is still a large advantagefor primary balloon angioplasty. Feasibility Mori vascular type have ainfluence on the feasibility, safety and results of operations, Mori C-typehas a low rate of surgical success, high rate of perioperative complicationand residual stenosis,also has poor prognosis. The more perforatorvessels, the more angioplasty complications will be. Residual stenosis after primary balloon angioplasty and the incidence of restenosis areheavier, but the prognosis is not worse than stenting.