| Background The most important cause of the ischemic stroke is intracranial atherosclerotic stenosis.Although the SAMMPRIS (Stenting and Aggressive Medical Management for Preventing Recurrent stroke in Intracranial Stenosis) results that drug is better than that of intracranial artery stenosis stent operatiom, but in recent years, many single center reports show that,for the patients who had been given antiplatelet therapy remained after ischemic events,it is necessary to undergoing stenting.In order to implant the stent more effectly,doctorts need to better observe the local vascular structure,position a stent more exactly,discover the complications more early.Since the Dyna-CT technology appeared in 2005, all of the problems are solved.Because the Dyna-CT technology has not been popular in China,so researchs on the application of Dyna-CT technique in intracranial stenting have not reported.Objective To study the application of Dyna-CT, and evaluate its application in the interventional therapy of symptomatic ICAD.Methods In our sutdy, three hundred forty-eight cases hospitalized suffering from TIA or cerebral infarction due to ICAD were collected between March 2007 and June 2013 in our unit and Changhai Hospital.All of them were divided into two groups:group A consisted of 179 patients who underwent stenting in the treatment in Siemens angiography machine room with Dyna-CT function,while the B group with 169 cases received stenting treatment in Philips angiography machine room without Dyna-CT function.Then,we compared the two groups of the following indicators:(1) The success rate of operation; (2) Stenting time; (3) the occurrence rate of operation complications; (4) the incidence rate of ISR; (5)the detection rate of atherosclerotic plaques; (6)mRS score difference.Data processing and analysis by use SPSS 17.0,and with P<0.05 difference has statistics significance.Results (1) The success rate of operation of group A was 97.8%; while group B was 98.2%.Total of 348 case,5 patients died,2 cases can not position the stenting correcly. (2) According to the record of intraoperative anesthesia,time consuming in stent implantation under local anesthesia and general anesthesia operation were respectively:A group 62.21 ± 21.916, B group 59.31 ± 14.807,P>0.05; but if general anesthesia angiography,then stenting,time respectivelyrin group A,99.88 ± 23.454, B group 99.82 ± 21.475,P>0.05. (3) Of 348 patients,21 cases occurred serious complications:8 cases occurred intraoperative hemorrhage,4 of them died;intraoperative thrombosis occurred in 5 cases,one of them died;6 patients after 24-48 hours had vascular infarction.Comparison of the risk of complications: A group 4.5%, B group 7.7%, P>0.05. (4) Comparison of the risk of ISR:group A was 15.4% while group B was 24.1%,P<0.05,A group was lower than that of B group; (5) In group of A,117 patients were found with intracranial vascular plaque,the detection rate is 66.9%,while in B group were 51 and 30.7%,P<0.05,there is significant difference between the two groups. (6) mRS score difference:in group A,0.41 ± 1.193, B group 0.40 ± 0.953, P>0.05.Conclusion Dyna-CT can betterly observe the atherosclerotic plaque,and may help to reduce the occurrence of ISR postoperatively.Therefore, in the treatment of patients with intracranial artery stenosis to use Dyna-CT is of clinical significance. |
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