Clinical Study Of Subacute Vascular Patency Of Cerebral Infarction With Subtotal Occlusion Of Internal Carotid Artery

Objective: To explore and evaluate the efficacy and safety of endovascular stent angioplasty in the treatment of subacute cerebral infarction with subtotal occlusion of middle cerebral artery.Methods: The basic and clinical data of 60 patients with sub acute cerebral infarction with secondary total occlusion of internal carotid artery admitted to our hospital from September 2017 to October 2019 were analyzed and selected.The patients were randomly divided into simple drug group(routine drug treatment for subacute cerebral infarction)and intravascular treatment group(balloon expansion based on routine drug treatment + stent placement),with 30 patients in each group.The general data,clinical symptoms and risk factors related to cerebral infarction were recorded.The scores of NIHSS and MRS before treatment and 7th,30 th,60th,90 th and 180 th days after treatment were recorded.The success rate of hand operation,vascular recanalization rate and PWI index(CBF)also recorded CBV,MTT,TTP and complications were analyzed.Results:1.There was no significant difference in sex,age,onset time,clinical symptoms and risk factors related to cerebral infarction between the two groups(P > 0.05);The data of the two groups were comparable,the length of stay in the intravascular treatment group was longer than that in the drug group(P < 0.05);2.The success rate of vascular intervention in the intravascular treatment group was 100%,the recanalization rate and symptom improvement rate were 96.7% and 93.3%,respectively;The revascularization rate and symptom improvement rate were 16.7% and 56.7% respectively in the drug group,the incidence of complications in the intravascular treatment group was significantly lower than that in the drug group(P < 0.01),and the improvement rate was significantly higher than that in the drug group(P < 0.001);The rate of restenosis was lower than that in the drug group(P < 0.05);3.After the 7th,30 th,60th,90 th and 180 th days after treatment,CBF and CBV of the patients in the intravascular treatment group were significantly higher than those before treatment(P < 0.01),MTT and TTP were significantly shorter than those before treatment(P < 0.01);NIHSS score average improved(3.44±2.15),it was significantly improved than those before treatment(P < 0.05),the mean improvement of m RS score was(1.63 ± 0.68),which was better than that before treatment(P < 0.05),and the improvement was better than that of the drug group(P < 0.05);4.There were no significant changes in CBF,CBV,MTT and TTP in the affected hemisphere 7th,30 th,60th,90 th and 180 th days after treatment in the simple drug group(P > 0.05);NIHSS score was average improved(2.40±1.71),m RS score was average improved(1.26±0.28),which had a significant changes than before treatment(P<0.05);5.There was no significant difference in PWI perfusion parameters between the two groups before treatment(P > 0.05),On the 7th,30 th,60th,90 th and 180 th day after treatment,CBF and CBV in the intravascular treatment group were higher than those in the drug group alone,while MTT and TTP were lower than those in the drug group alone(P < 0.01);There was no significant difference in NIHSS score and m RS score between the two groups before treatment(P > 0.05),After 7th,30 th,60th,90 th and 180 th day after treatment,NIHSS score and m RS score changes both were better than the drug group alone(P < 0.05).Conclusion:Endovascular stenting was safe and effective in the treatment of patients with subacute stage of subtotal occlusive cerebral infarction,which could effectively relieve the clinical symptoms of the patients and realize the recanalization of the diseased vessels,and compared with the simple drug treatment group,it could effectively reduce the incidence of complications.