1 main causes of ischemic cerebrovascular diseaseIschemic stroke accounts for the majority of cerebrovascular events, about 80%. Among the v
1 main causes of ischemic cerebrovascular disease
Ischemic stroke accounts for the majority of cerebrovascular events, about 80%. Among the various risk factors (hypertension, hyperlipidemia, diabetes, smoking, etc.), arterial stenosis is an independent risk factor for ischemic stroke. Extracranial artery (of intracranial vascular and carotid artery, extracranial vertebral artery) stenosis (mainly atherosclerotic stenosis) is the main pathological factors of ischemic stroke, about 70% of the ischemic stroke patients with intracranial and extracranial artery stenosis.
Cerebral angiography: the gold standard for the diagnosis of cerebrovascular disease
With the continuous development of science and technology of medical diagnosis, not previously diagnosis parts can now be easily diagnosed by angiography in the downlink of DSA brain, the diseased parts of cerebrovascular disease can be intuitive in developing, plays a decisive role in the late accurate symptomatic treatment, with others such as CT, magnetic resonance, check all the incomparable precise advantage.
2 what is cerebral angiography?
Cerebral angiography is a conventional and mature diagnostic method, which is used to explore the causes of stroke, the location of aneurysms and the choice of treatment. Methods cerebral angiography is a puncture in the thigh of the patient, through a thin and soft catheter in the internal carotid artery injection of contrast agent, continuous recording camera at the same time, contrast process, make clear the brain vascular image displayed on the TV screen and X rays, to determine cerebral arterial lesions with the doctor accordingly. To make an accurate diagnosis and treatment options.
3 treatment of cerebrovascular disease
The treatment of cerebrovascular disease is mainly drug treatment, surgical treatment and interventional therapy. Three kinds of methods, the effect of drug treatment is not ideal, surgery (carotid endarterectomy and extracranial vascular bypass) while effective treatment, but relatively more trauma, anesthesia, surgery can sometimes be blocking blood flow to the brain, can not happen again as repeat stenosis, and this kind of operation is carried out in Chinas not universal. Carotid endarterectomy complications is about 60%, the restenosis rate was 7~15%, or even higher, therefore, has many defects such as surgery, trauma, contraindications strictly strong, curative effect of dependence. Neural interventional therapy on cervical vessels (including carotid and vertebral artery stenosis) underwent endovascular stent surgery, with high success rate, minimal trauma, wide indications, restenosis (or recurrent) rate is low (about 5%) and repeated the advantage of endovascular stent not only can the direct treatment of the stenosis of the cerebral blood flow increased, cerebral ischemia improved, and can prevent or reduce the recurrence of stroke. Interventional therapy is a new therapeutic method, through the brain artery balloon dilatation and stent placement, the curative effect is reliable, safe operation, minimal trauma.
4 what is the stent angioplasty?
After cerebral angiography in diagnosis of cerebrovascular stenosis, according to the situation of cerebral vascular stenting, under fluoroscopy, the balloon is sent to the vascular lesions at the pressure, filling the balloon will narrow expansion, thus changing the blood supply, relieve symptoms. After the expansion of the lesion, the lesion will need stent permanent distraction, stent implantation is to reduce plaque rupture after acute occlusion of vascular collapse, and increase the safety of the surgery and reduce restenosis.
5 why do patients with ischemic cerebrovascular disease need cerebral angiography?
Vascular stenosis is the main cause of ischemic cerebrovascular disease, extracranial artery stenosis can be directly caused by cerebral ischemia, cerebral ischemia can cause secondary thrombosis, but also because of the stenosis of thrombosis or occlusion of a cerebral artery atherosclerotic plaque shedding caused by cerebral ischemia. Therefore, cerebral angiography is an important means of diagnosis of ischemic cerebrovascular disease. Only clear the location and nature of vascular lesions can be the source of the disease for the basic treatment.
6 what kind of vascular stenosis need to be treated with stents?
Endovascular stent is currently accepted treatment of arterial stenosis caused by ischemic cerebrovascular disease the most effective treatment method, general artery stenosis 70%, with or without symptoms, need to eliminate the intravascular stent in the treatment of stenosis, episodes of stroke prevention; blood vessel stenosis is less than 70%, as long as the cause of the vessel the disease symptoms, should be treated by endovascular stent treatment, if no symptoms can be observed; vascular stenosis is less than 30%, with ulcerative plaques, with or without symptoms, should be timely for endovascular stents.
7 what is the mechanism of endovascular stent therapy?
The mechanism of vascular stent in the treatment of ischemic cerebrovascular disease has the following three aspects: the artery stenosis, cerebral blood deficiency, the part of the brain cells in hypoxia, adjacent to the edge of death, a further decline once the blood pressure fluctuations or unexpected shock caused by the cerebral blood flow, this part the cells will necrosis, and once the vascular stenosis eliminated, increase cerebral blood flow, this part of the cell's function can be saved; the vessel wall plaque can fall off when not in a stable, smooth blood flow to the distal, distal vascular occlusion caused by. After stenting, the compression effect of stents, plaque instability can be suppressed, thereby preventing the loss; for ulcerative plaque, because the flow vortex is formed in the ulcer, thrombosis, stent by compression, the ulcer plaques disappeared.
8 how to prepare before the operation?
Before surgery, the patient should be signed by the consent of the family in the surgery, the eve of the operation according to the doctor's advice and full rest, the morning of the operation should be fasting, preoperative emptying urine.
9 how does it feel?
During the imaging process to create the shadow of the patient will feel the head or neck fever and discomfort, but the duration of only 1 - 2 seconds, a very small number of patients with nausea and vomiting. It may be normal to have a neck pain or chest pain similar to a angina attack, but these feelings should be immediately reported to the doctor.
10 should pay attention to what?
After surgery, patients should drink plenty of water to facilitate the removal of contrast agent, try not to eat a high protein diet within 24 hours, as far as possible not to move the legs of surgery and their own attention to observe the oppression of the place where there is no blood oozing. Must follow the doctor's advice after surgery, after discharge, according to the doctor's request back to the hospital.