Possibilities of Lowering Dementia Level During Transcatheter Treatment of Patients with Atherosclerotic Cerebral Lesions.

Abstract

Introduction The researchpurpose is the study of brain transcatheter laser revascularization efficacy inthe treatment of cerebral atherosclerosis accompanied by vascular dementia. Methods The investigation included 665 patients, 478 (71.87%) men, 187 (28.13%) women, aged40-81 (average age 75) with various types of atherosclerotic lesions of brainvessels accompanied by vascular dementia. All the patients underwent CT, MRI, SG, REG, MUGA. 639(96.09%) patients underwent transcatheter treatment revealing the following: 86patients had macrofocal strokes, 74 – medium focal strokes, 29 – single microfocalstrokes, 36 – multiple microfocal strokes, 273 patients – atheroscleroticlesions without strokes, 98 – arteriolosclerosis, 37 – atheroscleroticparkinsonism, 6 – Binswanger's disease. Of these, CDR-1 – 352 (55.09%), CDR-2 -184 (28.79%), CDR-3 – 103 (16.12%) patients. Forrevascularization of main intracranial arteries high-energy laser systems were used;for revascularization of distal intracranial branches low-energy laser systemswere used. Results Goodimmediate angiographic result – restoration of vascular lumen and patency and collateralrevascularization – was achieved in 628 (98.27%) cases. Goodclinical result (Index Bartels-IB-100): in group CDR-1 – 282 (80.11%), CDR-2 -81 (44.02%), CDR-3 – 9 (8.73%) cases. Satisfactory clinical result (IB-70-80):in group CDR-1 – 53 (15.06%), CDR-2 – 62 (33.70%), CDR-3 – 31 (30.09%) cases. Relatively satisfactory clinical result (IB-50-60): CDR-1 – 17 (4.83%), CDR-2 -41 (22.28%), CDR-3 – 63 (61.16%) cases. Conclusions Transcatheterlaser revascularization of cerebral blood vessels allows to significantlyreduce the level of dementia in patients with cerebral atherosclerosis.