Effect of haemodynamics on the risk of ischaemic stroke in patients with severe vertebral artery stenosis  

作　　者：Qing Li Yinghua Zhou Yingqi Xing Jie Yang Yang Hua 

机构地区：[1]Department of Vascular Ultrasonography,Xuanwu Hospital Capital Medical University,Beijing,China [2]Beijing Diagnostic Center of Vascular Ultrasound,Xuanwu Hospital Capital Medical University,Beijing,China [3]Center of Vascular Ultrasonography,Beijing Institute of Brain Disorders,Collaborative Innovation Center for Brain Disorders,Capital Medical University,Beijing,China

出　　处：《Stroke & Vascular Neurology》2022年第3期200-208,共9页卒中与血管神经病学（英文）

摘　　要：Objectives Endovascular treatment strategies to optimise individualised care for patients with vertebral artery(VA)stenosis need to be revisited.This study aimed to investigate the relationship between net VA flow volume(NVAFV)and the risk of posterior circulation infarction(PCI)in a high-risk patient population.Methods We screened 1239 patients with extracranial VA stenosis,of whom 321 patients with severe VA V1 segment stenosis(≥70%)were enrolled in our study.We restratified the patients based on NVAFV and contralateral VA stenosis grades to analyse the proportion of each PCI mechanism-large artery atherosclerosis and branch artery occlusive disease.Furthermore,we estimated the incidence of recurrent ischaemic stroke between groups with different NVAFV over a follow-up period of 2 years.Results NVAFV was lower in the PCI group.Multiple logistic regression analysis showed that NVAFV is an independent risk factor for PCI and that the OR for PCI for the lowest NVAFV(<112.8 mL/min)was 4.19(1.76 to 9.95,p=0.001).In patients with severe carotid artery disease,the OR for the lowest NVAFV was 14.03(3.18 to 61.92,p<0.001).The lower NVAFV group had a higher incidence of recurrent ischaemic stroke events than the higher NVAFV group(HR 2.978,95%CIs 1.414 to 6.272).Conclusion Our study demonstrated that NVAFV,as estimated by colour duplex ultrasonography,was associated with the incidence of PCI and subsequent ischaemic events and that a high-risk population could be identified for further posterior circulation revascularisation.

关 键 词：PATIENTS STENOSIS VERTEBRAL 

分 类 号：R743[医药卫生—神经病学与精神病学]