To evaluate whether recanalization and stenting for symptomatic subacute and chronic veterbrobasilar artery occlusion is technically feasible, can prevent from recurrent ischemic events and promotes functional recovery of disability.
Ischemic stroke accounts for 87% of cerebrovascular accidents. Of these, a part is the result of intracranial veterbrobasilar occlusion. Acute veterbrobasilar artery occlusion is a devastating disease with high mortality without successful treatment. A subset of patients can survive the acute phase and develop subacute or chronic veterbrobasilar artery occlusion. Due to the adequacy of collaterals, some patients can live without any or just very mild symptoms. On the contrast, lack of enough collaterals, another patients still presented with recurrent ischemic events and progressive disability despite intensive medical therapy. Prognosis is extremely poor. It is in this cohort that subacute or chronic revascularization is often considered. The optimal treatment in this cohort with non-acute veterbrobasilar artery occlusion is unknown, and there is little literature to guide therapy. Extracranial-intracranial bypass may revascularize the intracranial artery occlusion. However, bypass procedures are technically challenging and are associated with significant risk of morbidity and mortality. Recurrent ischemic symptoms despite best medical treatment be indication for endovascular revascularization and stent remodeling. This study was to evaluate the technical feasibility, safety and treatment effects of recanalization and stenting for veterbrobasilar subacute-chronic intracranial artery occlusion。
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Apollo stent (MicroPort Medical, China),Neuroform stent (Stryker/Boston Scientific, USA) or Wingspan stent (Stryker/Boston Scientific, USA), et al.
Henan Provincial People'S Hospital
Zhengzhou, Henan, China
Henan provincial intervention therapy center
Zhengzhou, Henan, China
Change from Baseline in Modified Rankin Scale at Six Months postoperative
Modified Rankin Scale (mRS) was used to evaluate the level of disability
Time frame: six months to two years
Changes from Baseline in Modified Rankin Scale (mRS) at one year postoperative
Time frame: one to three years
Number of Participants with Adverse Events
1. hemorrhagic or ischemic 2. ipsilateral or non-ipsilateral 3. disability or non-disability 4. the causes 5. others
Time frame: up to three years
Changes from Baseline in NIHSS (National Institutes of Health Stroke Scale) at Six Months postoperative
NIHSS (National Institutes of Health Stroke Scale) is used to evaluate the severity of neurological deficit.
Time frame: six months to two years
Rate of Successful Recanalization
Antegrade blood flow through the recanalized portion was assessed by thrombolysis in myocardial infarction (TIMI) score or thrombolysis in cerebral infarction (TICI) score. TIMI≥2 or TICI≥2b was defined as successful recanalization.
Time frame: two years
Changes from Baseline in BI (Barthel Index) at Six Months postoperative
BI (Barthel Index) is used to evaluate activities of daily living.
Time frame: six months to two years
Changes from Baseline in WHOQOL-BREF (The World Health Organization Quality of Life - BREF)at Six Months postoperative
WHOQOL-BREF (The World Health Organization Quality of Life - BREF) is used to evaluate the individual's perceptions in the context of their culture and value systems, and their personal goals, standards and concerns.
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Time frame: six months to two years