Kang Kaijiang, Yang Bo, Gong Xiping, Chen Xing, Gu Weibin, Ma Guofeng, Miao Zhongrong, Zhao Xingquan, Ma Ning
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.
Front Neurol. 2020 May 5;11:318. doi: 10.3389/fneur.2020.00318. eCollection 2020.
We performed this study to evaluate the hemodynamic changes over time after successful endovascular recanalization in patients with symptomatic chronic intracranial artery occlusion (CIAO). We included 20 patients with symptomatic CIAO in a high-volume stroke center from June 2014 to June 2019. All subjects were evaluated with CT perfusion (CTP) studies before and after the recanalization. The relative cerebral blood flows (rCBFs) in perforating artery territory (PAT) and cortical artery territory (CAT) of occluded arteries were compared before and after the recanalization. The patients were categorized into subgroups based on the time interval from revascularization to post-procedural CTP, occlusion sites, and restenosis status. The proportion of rCBF change (rCBFc%) was compared in variable subgroups. The rCBF increased significantly from 0.52 to 0.71 in PAT ( < 0.001) and from 0.59 to 0.85 in CAT ( < 0.001) after recanalization, and there were also statistical differences in variable subgroups except for those with restenosis. The median and interquartile range (IQR) of rCBFc% were 35.2 and 18.6-56.6%. For patients with short-term follow-up (55.2%), the rCBFc% was relatively higher than that in patients with mid-term (35.4%) and long-term follow-up (32.7%), although without statistical difference ( = 0.273). For patients with restenosis, the rCBFc% was significantly lower than that in patients without restenosis (18.5 vs. 37.3%, = 0.008). In patients with symptomatic CIAO, the CBF may increase and be relatively stable over time after successful recanalization except for restenosis.
我们开展这项研究，以评估有症状的慢性颅内动脉闭塞（CIAO）患者成功进行血管内再通术后随时间推移的血流动力学变化。2014年6月至2019年6月期间，我们纳入了一家大型卒中中心的20例有症状的CIAO患者。所有受试者在再通术前和术后均接受了CT灌注（CTP）研究。比较了闭塞动脉的穿支动脉区域（PAT）和皮质动脉区域（CAT）再通术前和术后的相对脑血流量（rCBF）。根据从血运重建到术后CTP的时间间隔、闭塞部位和再狭窄状态将患者分为亚组。比较了不同亚组中rCBF变化比例（rCBFc%）。再通术后，PAT的rCBF从0.52显著增加至0.71（<0.001），CAT的rCBF从0.59显著增加至0.85（<0.001），除再狭窄患者外，不同亚组之间也存在统计学差异。rCBFc%的中位数和四分位间距（IQR）分别为35.2和18.6 - 56.6%。对于短期随访的患者（55.2%），rCBFc%相对高于中期随访（35.4%）和长期随访（32.7%）的患者，尽管无统计学差异（=0.273）。对于有再狭窄的患者，rCBFc%显著低于无再狭窄的患者（18.5%对37.3%，=0.008）。在有症状的CIAO患者中，成功再通术后，除再狭窄外，CBF可能会增加并随时间相对稳定。
