Effects of balloon dilatation combined with Solitaire stent on vascular patency and prognosis in patients with acute in-tracranial large vessel occlusion accompanied by atherosclerosis

Zhang Longxing; Chen Jie; Chen Yanjun; Wu Xuemei

doi:10.3969/j.issn.1671-6450.2023.12.005

Abstract：Objective To investigate the effect of balloon dilatation combined with Solitaire stent on vascular pa-tency and prognosis in patients with acute intracranial large vessel occlusion accompanied by atherosclerosis.Methods From January 2016 to May 2022,82 patients with acute intracranial large vessel occlusion accompanied by atherosclerosis were selected from the Department of Neurology,General Hospital of Taiyuan Iron and Steel(Group)Co.,Ltd.They were randomly divided into two groups:the control group and the observation group,with 41 cases in each group.The control group received Solitaire stent treatment,while the observation group received balloon dilation combined with Solitaire stent treatment.Observe 2 groups of surgical related indicators,vascular recanalization status,preoperative and postoperative 3-day cerebral blood flow perfusion[relative cerebral blood flow(rCBF),relative peak time(rTTP),relative mean transit time(rMTT),relative cerebral blood volume(rCBV)],vascular endothelial function[von Willebrand factor(vWF),endothelin-1(ET-1),nitric oxide(NO)],preoperative and discharge coma risk(GCS score)Degree of neurological impairment(NIHSS score),cognitive function(MOCA score),and complications.Results The observation group had fewer thrombus removal times than the control group,and the immediate postoperative vascular diameter was greater than the control group(t/P=5.162/＜0.001,3.446/0.001);There was no statistically significant difference in blood vessel recanalization rate between the observation group and the control group(P＞0.05);On the 3rd day after surgery,the rCBF level in the observation group was higher than that in the control group,while the rMTT and rTTP levels were lower than those in the control group(t/P=2217/0.029,4.714/＜0.001,4.919/＜0.001);The serum vWF and ET-1 levels in the observation group were lower than those in the control group 3 days after surgery,while the NO levels were higher than those in the control group(t/P=6.770/＜0.001,12.292/＜0.001,8.726/＜0.001);At discharge,the GCS and MOCA scores of the observation group were higher than those of the control group,while the NIHSS scores were lower than those of the control group(t/P=3.326/0.001,6.163/＜0.001,10.584/＜0.001);There was no statistically significant difference in the total incidence of complications between the observation group and the control group(P＞0.05).Conclusion Balloon dilatation combined with Solitaire stent in the treat-ment of acute intracranial large vessel occlusion with atherosclerosis can reduce the number of embolectomy,increase the diameter of blood vessels,improve the endothelial function of blood vessels,contribute to cerebral blood flow perfusion,promote disease prognosis,and have high safety.