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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Endovascular Therapy of Cerebral Arterial Occlusions: Intracranial Atherosclerosis versus Embolism
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Endovascular Therapy of Cerebral Arterial Occlusions: Intracranial Atherosclerosis versus Embolism

机译：脑动脉闭塞的血管内治疗：颅内动脉粥样硬化与栓塞

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Background: Treatment strategy for acute arterial occlusions due to intracranial atherosclerotic disease (IAD) may differ from those due to embolism (embolic). The aims were to differentiate and classify angiographically defined occlusion due to IAD versus embolism and identify baseline clinical factors associated with IAD-related occlusion. Methods: Acute ischemic stroke patients with large cerebral artery occlusions on computed tomography angiography who underwent transfemoral cerebral angiography for endovascular treatment were included. Patients were categorized as the embolic (no evidence of focal stenosis after recanalization) or IAD group (significant fixed focal stenosis in the occlusion site, evidenced in the final angiography or during the endovascular treatment procedure) based on transfemoral cerebral angiography findings. Results: In total, 158 patients were included. The IAD group patients (n = 24) were younger (P = .005), more often male (P .001) and smokers (P .001), and had a higher total cholesterol level (P = .001) than patients in the embolic group (n = 134). The posterior circulation was more frequently involved in the IAD group (P = .001). Independent predictors of IAD on multivariable analysis were male sex (odds ratio, 6.42 [95% confidence interval, 1.25-32.97], P = .026), posterior circulation involvement (3.57 [1.09-11.75], P = .036), and high total cholesterol levels (1.02 [1.01-1.03], P = .008). Conclusions: Male sex, hypercholesterolemia, and posterior circulation involvement are associated with higher likelihood of underlying IAD as the etiology for the intracranial arterial occlusion. In patients with these characteristics, underlying IAD may have to be considered and the endovascular treatment strategy may have to be modified. (C) 2015 by National Stroke Association
机译：背景：由于颅内动脉粥样硬化疾病（IAD）引起的急性动脉闭塞的治疗策略可能与栓塞（栓塞）不同的侵扰性。目的是区分和分类由于IAD与栓塞而分类的血管造影定义的闭塞，并确定与IAD相关闭塞相关的基线临床因素。方法：急性缺血性脑卒中患者患有大脑动脉闭塞对计算机断层造影的血管造影，包括接受血管内血管造影进行血管血管造影的血管造影。患者被归类为栓塞（没有局灶性狭窄的证据）或IAD组（闭塞位点的显着固定局灶性狭窄，在血管内造影或期间在血管内治疗程序中证明）基于经血法脑血管造影结果。结果：总共包括158名患者。 IAD组患者（n = 24）较年轻（P = .005），更常见的是雄性（P＆ .001）和吸烟者（P <.001），总胆固醇水平较高（P = .001 ）比栓塞组（n = 134）的患者。 IAD组更常见的后循环（P = .001）。 IAD对多变量分析的独立预测因子是男性性别（差距，6.42 [95％置信区间，1.25-32.97]，P = .026），后循环受累（3.57 [1.09-11.75]，p = .036），和高总胆固醇水平（1.02 [1.01-1.03]，p = .008）。结论：男性性，高胆固醇血症和后循环受累与潜在的IAD潜在颅内动脉闭塞的病因有关。在这些特征的患者中，可能必须考虑下面的IAD，并且可能需要修改血管内治疗策略。 （c）2015年国家冲程协会

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