Symptomatic Cerebral Artery Stenosis Research Articles

A Follow-up Study of Cerebral Microbleeds in Patients Who Received Stents for Symptomatic Cerebral Artery Stenosis

The aims of this study were to explore (i) the dynamic changes in cerebral microbleeds (CMBs) in patients with symptomatic cerebral artery stenosis who received endovascular stent-assisted angioplasty and (ii) the risk factors associated with the new incidence of CMBs as well as whether CMBs increased the risk of vascular events in these patients. Clinical information and magnetic resonance images were collected on admission and 3 months after endovascular stent-assisted angioplasty. Based on susceptibility-weighted imaging, the patients were divided into groups with or without newly developed CMBs, and between-group differences in risk factors were compared. We also compared whether CMBs increased the risk of vascular events among those patients. Seventy-three patients completed the relevant follow-up examinations. After an average follow-up period of 109days, 7 (9.6%) patients showed new CMBs. A univariate analysis showed that the number of lacunar infarcts and the increase in systolic blood pressure were higher in patients with new CMBs than in those without new CMBs, and these differences were significant (P=0.034, P=0.001). Increased systolic blood pressure was an independent risk factor for developing new CMBs (P=0.017). CMBs may be a continuously progressing cerebral small-vessel disease. Thenewly developed CMBs in patients with intracranial and/or extracranial stents were associated with increased systolic blood pressure but not with the number of baseline CMBs.

Studies about the correlation of sleep apnea hypopnea syndrome with symptomatic cerebral artery stenosis

To investigate the possible correlation of sympotoms of cerebral artery stenosis and sleep apnea hypopnea syndrome. A total of 131 patients that proved to suffer from cerebral artery stenosis by digital subtraction angiography (DSA) were enrolled.These patients were divided into three groups according to the position of cerebral artery stenosis (Group A: internal carotid artery stenosis; Group B : vertebral basilar artery stenosis; Group C: internal carotid artery and vertebral basilar artery stenosis). All the patients underwent apolysomnography(PSG) and correlative parameters were compared. Of 131 cases of cerebral artery stenosis, SAHS patients was up to 106 cases (81%). The incidence of SAHS between the three groups had no significant difference. But the apnea hypopnea index (AHI), the average oxygen desaturation index (AODI) of group B and group C were higher than those of group A. The events of sleep apnea of Group C is higher than Group A. There is a high morbidity rate of SAHS in patients with symptomatic cerebral artery stenosis. The morbidity rate of SAHS has no significant difference with the section of vascular stenosis. But the degree of SAHS is heavier in the patients that with vertebral basilar artery stenosis, internal-vertebral basilar artery stenosis, the lateral appears to experience various types of apnea events.

Angiographic CT after Intravenous Contrast Agent Application: A Noninvasive Follow-Up Tool after Intracranial Angioplasty and Stenting

ICAS is one of the therapeutic options in symptomatic cerebral artery stenosis. iaDSA is the current criterion standard examination after ICAS for the detection of ISR. In this study, we evaluated ivACT as a potential noninvasive follow-up alternative. In 17 cases, ivACT and iaDSA were performed after ICAS. Both procedures were carried out on a flat-panel-detector-equipped angiography system. Postprocessing of ivACT acquisitions was performed on a dedicated workstation producing multiplanar reformations of the stent region and other intracranial arteries. Restenotic lesions were compared with iaDSA measurements. All studies were independently evaluated by 2 experienced neuroradiologists blinded to patients data. In 5 cases, ISR was diagnosed on iaDSA images. All restenotic lesions were reliably detected (sensitivity, 100%; 95%CI, 48%-100%) and could be correctly quantified on ivACT images in comparison with iaDSA. The neuroradiologists correctly excluded ISR in 11 of 12 lesions after viewing the ivACT examinations (specificity, 92%; 95%CI, 62%-100%). Measurements of ISR on ivACT were highly correlated to iaDSA (Pearson r = 0.94, P < .01). IvACT is a promising noninvasive follow-up examination after ICAS. With its high spatial resolution, it can reliably detect or exclude ISR. Contrary to iaDSA, there is no need for a recovery period after ivACT and the risk of neurologic complications is practically lowered to zero.