Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan.
National Yang Ming University, School of Medicine, Taipei, Taiwan.
Sci Rep. 2020 Mar 3;10(1):3923. doi: 10.1038/s41598-020-60906-6.
Stenotic lesion rigidity (SLR) has an unclear influence on the outcome of percutaneous transluminal angioplasty and stenting (PTAS) for intracranial arterial stenosis. This study evaluated the outcome of PTAS and the relationship of vertebrobasilar SLR to features on vessel wall MRI (VW-MRI) for identifying pathologies of vertebrobasilar stenosis (VBS) and evaluating PTAS outcome. We retrospectively evaluated the results of PTAS in 31 patients with severe VBS. Stenotic lesions were classified as soft (based on predilatation pressure [PP] ≦ 4 atm) in 15 patients or hard (PP >4 atm) in 16 patients. We examined the relationship of SLR to clinical and MR findings. Patients with hard vs soft lesions had atherosclerosis (8/16 [50.0%] vs 2/15 [13.3%]), dissection (0/16 [0.0%] vs 12/15 [80.0%]), and dissection in atherosclerosis (8/16 [50.0%] vs 1/15 [6.7%], P < 0.0001); high intensity signal on the T1WI of VW-MRI (5/16 [31.3%] vs 14/15 [93.3%]) and iso- to low intensity signal (11/16 [68.7%] vs 1/15 [6.7], P = 0.001), and significant in-stent restenosis (>50%) in 5/15 (33.3%) vs 0/15 (0.0%) (P = 0.0421) in the 30 patients who successfully completed PTAS. Vertebrobasilar SLR correlated well with lesion etiology, findings on VW-MRI, and PTAS outcome. Patients with hard stenotic lesions need close follow-up after PTAS.
狭窄病变硬度（SLR）对颅内动脉狭窄经皮腔内血管成形术和支架置入术（PTAS）的结果影响尚不明确。本研究评估了 PTAS 的结果，以及椎基底动脉 SLR 与血管壁 MRI（VW-MRI）特征的关系，以识别椎基底动脉狭窄（VBS）的病变，并评估 PTAS 的结果。我们回顾性评估了 31 例严重 VBS 患者的 PTAS 结果。15 例狭窄病变为软病变（基于预扩张压[PP]≤4 大气压），16 例为硬病变（PP＞4 大气压）。我们研究了 SLR 与临床和 MR 发现的关系。硬病变组与软病变组相比，动脉粥样硬化（8/16 [50.0%] vs 2/15 [13.3%]）、夹层（0/16 [0.0%] vs 12/15 [80.0%]）和动脉粥样硬化夹层（8/16 [50.0%] vs 1/15 [6.7%]）的比例更高（P<0.0001）；VW-MRI 的 T1WI 上高信号（5/16 [31.3%] vs 14/15 [93.3%]）和等至低信号（11/16 [68.7%] vs 1/15 [6.7%]），以及在 30 例成功完成 PTAS 的患者中，支架内再狭窄（>50%）5/15（33.3%）vs 0/15（0.0%）（P=0.0421）。椎基底动脉 SLR 与病变病因、VW-MRI 表现和 PTAS 结果密切相关。PTAS 后硬狭窄病变患者需要密切随访。
