Objective: By observing the relation between middle cerebral artery stenosis or occlusion patients with ipsilateral extracranial carotid artery hemodynamics changes, to identify the value of hemodynamic change of extr...Objective: By observing the relation between middle cerebral artery stenosis or occlusion patients with ipsilateral extracranial carotid artery hemodynamics changes, to identify the value of hemodynamic change of extracranial carotid artery in predicting the middle cerebral artery stenosis, in order to improve the detection rate and accuracy. Methods: Eighty-three patients with unilateral severe middle cerebral artery stenosis or occlusion who confirmed by MRA were enrolled in the study, in all case were detected by TCD. The relationship of hemodynamic between extracranial carotid arteries and intracranial carotid arteries were analyzed. Results:The patients with severe middle cerebral artery stenosis or occlusion tend to have lower velocity and higher pulsitility index (PI). The PI(iCA), Vm(iCA) has a certain significance. The PI difference of carotid artery, end diastolic velocity of internal carotial artery (Vd (iCA) ) can evaluate stenosis of MCA more sensitive. The PI difference of common carotid artery=0.13, PI difference of internal carotid artery=0.15, Vd (iCA) =13.8 cm/s, Yonden index were 0.709, 0.710, 0.601.Sensitivity were 80.49%, 78.05%, 80.49%.Specificity were 90.48%, 92.86%, 78.57%;Positive predictive value were 89.20%, 91.42%, 78.57%.Negative predictive value were 82.60%, 81.25%, 80.48%. Conclusion: The patients tend to have lower velocity and higher PI. The PI difference of carotid artery, Vd(iCA), PI(iCA), Vm (iCA) severe middle cerebral artery stenosis or occlusion can be evaluated and provide a basis for the early diagnosis.展开更多
本研究探讨经桡动脉入路(Transradial Approach, TRA)右侧大脑中动脉支架成形术的可行性、安全性和手术技巧。实验按照随机数表法将符合大脑中动脉支架成形术纳入标准的急性脑梗死患者分为观察组和对照组。观察组给予经TRA右侧大脑中动...本研究探讨经桡动脉入路(Transradial Approach, TRA)右侧大脑中动脉支架成形术的可行性、安全性和手术技巧。实验按照随机数表法将符合大脑中动脉支架成形术纳入标准的急性脑梗死患者分为观察组和对照组。观察组给予经TRA右侧大脑中动脉支架成形术,对照组给予经股动脉入路(Transfemoral Approach, TFA)右侧大脑中动脉支架成形术,对比分析2组患者导引导管到位情况、支架置入成功率、路径差异相关并发症、手术操作时间、射线投射时间、术后住院时间和手术费用。结果显示,观察组导引导管到位成功率为93.10%(27/29),对照组导引导管到位成功率100%,2组患者支架置入成功率均较高,路径差异相关并发症较低,手术操作时间、射线投射时间和手术费用相似,差异无统计学意义。基于主动脉弓型的亚组分析,观察组Ⅲ型主动脉弓患者手术操作时间(min)、射线投射时间(min)均短于对照组(73.8±15.3 vs 89.5±14.4;22.1±5.5 vs 28.4±8.3),差异有统计学意义(t=0.192,P=0.000;t=0.117,P=0.000)。与对照组相比,观察组患者术后住院天数明显减少(2.8±0.6 vs 4.2±0.8),差异有统计学意义(t=0.230,P=0.002)。因此,经TRA右侧大脑中动脉支架成形术成功率高,对于Ⅲ型主动脉弓患者采用该项方案能减少手术时间和射线投射时间,且术后住院天数少,可行性好。展开更多
基金Hainan Provincial Natural Science Foundation of China.Project No:818MS180.
文摘Objective: By observing the relation between middle cerebral artery stenosis or occlusion patients with ipsilateral extracranial carotid artery hemodynamics changes, to identify the value of hemodynamic change of extracranial carotid artery in predicting the middle cerebral artery stenosis, in order to improve the detection rate and accuracy. Methods: Eighty-three patients with unilateral severe middle cerebral artery stenosis or occlusion who confirmed by MRA were enrolled in the study, in all case were detected by TCD. The relationship of hemodynamic between extracranial carotid arteries and intracranial carotid arteries were analyzed. Results:The patients with severe middle cerebral artery stenosis or occlusion tend to have lower velocity and higher pulsitility index (PI). The PI(iCA), Vm(iCA) has a certain significance. The PI difference of carotid artery, end diastolic velocity of internal carotial artery (Vd (iCA) ) can evaluate stenosis of MCA more sensitive. The PI difference of common carotid artery=0.13, PI difference of internal carotid artery=0.15, Vd (iCA) =13.8 cm/s, Yonden index were 0.709, 0.710, 0.601.Sensitivity were 80.49%, 78.05%, 80.49%.Specificity were 90.48%, 92.86%, 78.57%;Positive predictive value were 89.20%, 91.42%, 78.57%.Negative predictive value were 82.60%, 81.25%, 80.48%. Conclusion: The patients tend to have lower velocity and higher PI. The PI difference of carotid artery, Vd(iCA), PI(iCA), Vm (iCA) severe middle cerebral artery stenosis or occlusion can be evaluated and provide a basis for the early diagnosis.
文摘本研究探讨经桡动脉入路(Transradial Approach, TRA)右侧大脑中动脉支架成形术的可行性、安全性和手术技巧。实验按照随机数表法将符合大脑中动脉支架成形术纳入标准的急性脑梗死患者分为观察组和对照组。观察组给予经TRA右侧大脑中动脉支架成形术,对照组给予经股动脉入路(Transfemoral Approach, TFA)右侧大脑中动脉支架成形术,对比分析2组患者导引导管到位情况、支架置入成功率、路径差异相关并发症、手术操作时间、射线投射时间、术后住院时间和手术费用。结果显示,观察组导引导管到位成功率为93.10%(27/29),对照组导引导管到位成功率100%,2组患者支架置入成功率均较高,路径差异相关并发症较低,手术操作时间、射线投射时间和手术费用相似,差异无统计学意义。基于主动脉弓型的亚组分析,观察组Ⅲ型主动脉弓患者手术操作时间(min)、射线投射时间(min)均短于对照组(73.8±15.3 vs 89.5±14.4;22.1±5.5 vs 28.4±8.3),差异有统计学意义(t=0.192,P=0.000;t=0.117,P=0.000)。与对照组相比,观察组患者术后住院天数明显减少(2.8±0.6 vs 4.2±0.8),差异有统计学意义(t=0.230,P=0.002)。因此,经TRA右侧大脑中动脉支架成形术成功率高,对于Ⅲ型主动脉弓患者采用该项方案能减少手术时间和射线投射时间,且术后住院天数少,可行性好。
