[Collateral circulation pathway in patients with basilar artery occlusion/severe stenosis: a single-center case
1Department of Neurology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China.
Insights
Patients with basilar artery occlusion/severe stenosis showed favorable outcomes with either intensive drug therapy or endovascular therapy. Collateral circulation compensation models varied between treatment groups, influencing outcomes.
Area of Science:
- Neurology
- Vascular Neurology
- Medical Imaging
Background:
- Basilar artery occlusion/severe stenosis poses significant risks.
- Understanding collateral circulation is crucial for treatment strategies.
- Favorable prognosis is achievable with appropriate interventions.
Purpose of the Study:
- To investigate collateral circulation compensation models.
- To compare models in patients treated with drugs versus endovascular therapy.
- To correlate compensation patterns with clinical outcomes.
Main Methods:
- Retrospective analysis of 32 patients with basilar artery occlusion/severe stenosis.
- Division into intensive drug therapy and endovascular therapy groups.
- Assessment of collateral pathways using digital subtraction angiography (DSA).
Main Results:
- Posterior communicating artery-posterior cerebral artery was a common compensation model (40.6%).
- Collateral compensation was more prevalent in the drug therapy group (93.3%).
- Endovascular therapy group showed less collateral compensation, with cerebellar artery routes being prominent.
Conclusions:
- Both intensive drug therapy and endovascular therapy can lead to favorable outcomes.
- Collateral compensation patterns differ between treatment modalities.
- Further research into optimizing collateral compensation is warranted.
Abstract:
Objective: To investigate the collateral circulation compensation model in patients with favorable prognosis of basilar artery occlusion/severe stenosis treated with drugs or endovascular therapy. Methods: Clinical data of patients with basilar artery occlusion/severe stenosis and good clinical outcome were retrospectively collected in the Department of Neurology, Sixth Medical Center of PLA General Hospital from January 2019 to January 2020. They were divided into intensive drug therapy group and combined endovascular therapy group. The number and ways of collateral compensation pathway described by digital substraction angiography (DSA) were analyzed, and the characteristics of the collateral compensation model were summarized. SPSS22.0 software was used for statistical analysis, and the constituent ratio (%) was used for statistical description of the enumeration data. Results: A total of 32 eligible patients were included, including 27 males and 5 females, with an average age 45-76 (59±10) years. The compensation model included posterior communicating artery-posterior cerebral artery (13 cases, 40.6%), posterior communicating artery-posterior cerebral artery-basilar artery (10 cases, 31.2%), cerebellar artery-anastomotic branches of superior cerebellar artery (8 cases, 25.0%), anterior choroid artery-anastomotic branches of posterior choroid artery (2 cases, 6.2%), collateral circulation not established (11 cases, 34.4%).In drug treatment group, collateral compensation was found in the majority (14/15), with mainly posterior communicating artery (10/14).Most patients in combined treatment group did not develop collateral compensation (10/17), anastomotic branches of PICA-SCA were the main routes (6/7). Conclusion: In patients with basilar artery occlusion/severe stenosis, favorable clinical outcome can be achieved in both groups of patients treated with intensive drug therapy or endovascular therapy.
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