Intracranial Segment Of Vertebral Artery Research Articles

Correlation between characteristics of intracranial atherosclerotic plaques and ischemic stroke in high-resolution vascular wall MRI.

Intracranial atherosclerotic stenosis is a major cause of ischemic stroke, accounting for 30% of ischemic strokes in Asian populations. To investigate the relationship between the degree of arterial stenosis and enhancement grade of intracranial atherosclerotic disease (ICAD), the plaque characteristics in different remodeling patterns, and its potential impact. A total of 210 patients diagnosed with ICAD were enrolled in this retrospective study. Patients were divided into the middle cerebral artery (MCA) group (101 cases), posterior cerebral artery (PCA) group (14 cases), basilar artery (BA) group (71 cases), and intracranial segment of vertebral artery (VA) group (90 cases) according to the difference of diseased vessels. Data on presence or absence of ischemic infarction, intracranial vascular position of lesions, plaque characteristics, ICAD enhancement grade, remodeling index, and degree of arterial stenosis were collected for analysis. The incidence of ischemic infarction in enhancement grade 2 was significantly higher than that in enhancement grade 1 in MCA group (P = 0.019). Enhancement grade 2 of ICAD was an independent risk factor for the development of ischemic infarction (odds ratio = 4.60; 95% confidence interval: 1.91-11.03; P = 0.001). There was no significant statistical difference in infarct rate between different remodeling modalities (P>0.05). Enhancement grade of ICAD is significantly associated with the degree of stenosis and the occurrence of ischemic stroke, which varies in different intracranial vessels. The pattern of vascular remodeling varies among different intracranial vessels, and the pattern of vascular remodeling has a significant impact on plaque characteristics.

Microsurgical management of posterior circulation aneurysms

Objective To retrospectively analyze effective methods for surgical management of posterior circulation aneurysms. Methods There were 42 patients with posterior circulation aneurysms [26 cases of basilar aneurysm (27 aneurysms), 16 cases of vertebral aneurysm (17 aneurysms)]. There were 15 patients underwent bypass surgery [4 external carotid artery ⁃ P2 segment of posterior cerebral artery (ECA ⁃ P2), 2 internal carotid artery ⁃ P2 segment of posterior cerebral artery (ICA ⁃ P2), 2 internal maxillary artery⁃P2 segment of posterior cerebral artery (IMA⁃P2), 2 intracranial segment of vertebral artery⁃extracranial segment of vertebral artery, 5 occipital artery⁃posterior inferior cerebellar artery (OA⁃PICA)] and 27 patients underwent simple surgical clipping. Results Activities of daily life of 37 patients recovered to normal (14 patients with aneurysm on the top of basilar artery, 3 with aneurysm on the trunk of basilar artery, 9 with vertebral aneurysm, 5 with posterior inferior cerebellar artery aneurysm, 4 with aneurysm on the junction of P1-P2 segment of posterior cerebral artery, 1 with superior cerebellar artery, and 1 with anterior inferior cerebellar aneurysm). None of them occurred operation ⁃ related neurological dysfunction. The recovery rate was 88.09% . Among the other patients, 1 with aneurysm on the top of basilar artery presented severe signs and symptoms of neurological defect and cannot take care of oneself, 2 patients (1 with aneurysm on the top of basilar artery, 1 with aneurysm on the trunk of basilar artery) occurred brain stem hemorrhage after operation, and died at perioperative period, 2 with vertebral aneurysm relapsed and was cured after treatment. Conclusion Posterior circulation aneurysm which is not suitable for surgical clipping can be treated with intra⁃ and extra⁃cranial vessel bypass. It may avoid the risk of surgical clipping of aneurysm. DOI：10.3969/j.issn.1672⁃6731.2012.01.011

FP06-MO-02 Economy class stroke in Hong Kong

interest artery include intracranial segment of internal carotid, intracranial segment of vertebral artery, basilar artery, middle cerebral artery. The technical success rate, average stenosis before and after treatment, major complications and clinical outcome were recorded. Conventional angiography was performed at 6 months after stenting to evaluate the patency of stent. Results: The average pretreatment stenosis was 80.6±12.1%. After Wingspan stent deployment, the average stenosis was 14.3±10.2%. The technical success rate was 100%. The rate of ipsilater stroke within 30 days and 6 months was 6.3% and 12.5%, respectively. The symptoms were significantly improved in 68.8% patients. Five patients underwent CT angiography, and in-stent stenosis was detected in one patient with 80% restenosis. Conclusion: Symptomatic intracranial artery stenosis can be treated with Wingspan stent with a high rate of technical success, acceptable safety and favorable clinic outcome.