An ischemic stroke occurs when an artery supplying the brain with blood
is obstructed by a blood clot. It is almost always caused by the accumulation
of fatty deposits along blood vessel walls—a condition known as
atherosclerosis, or hardening of the arteries. It is one of the most common pathological conditions both in
neurological practice and in all clinical medicine.
In this study, the authors investigated the efficacy of brain
transcatheter laser revascularization in patients who had extensive ischemic
stroke. 1125 patients aged 29 - 81 (average age 75) with cerebral atherosclerosis
were examined. The examination plan included: CT brain scan, magnetic resonance
imaging (MRI), brain scintigraphy (SG), rheoencephalography (REG), cerebral
multi-gated angiography (MUGA), laboratory tests, assessment of severity of
dementia (CDR), cognitive impairment (MMSE) and activities of daily living
(IB). 93 patients suffered extensive ischemic stroke of whom 7
(7.53%) had 10 - 15 IB points, 25 (26.88%)—20 - 30 IB points, 61 (65.59%)—35
- 45 IB points. 69 patients underwent transcatheter treatment (Test Group). 24
patients underwent conservative treatment (Control Group). High-energy laser
systems were used for revascularization of major intracranial arteries;
lowenergy laser systems were used for revascularization of distal
intracranial branches.
The result showed that test Group: 67 (97.10%) patients had good
immediate angiographic outcome manifested in the restoration of lumen and
patency of the affected vessels as well as in collateral revascularization. 12
- 24 months later the following positive trend was observed: 14 (20.59%)
patients demonstrated good clinical outcome (IB 90 - 100); 26 (38.24%) patients
had satisfactory clinical outcome (IB 75 - 85); 28 (41.18%) patients showed
relatively satisfactory clinical outcome (IB 60 - 70); relatively positive
clinical outcome (IB < 60) was not obtained in any case. Control Group: 4
(16.67%) patients showed relatively satisfactory clinical outcome (IB 60 -
70), relatively positive clinical outcome (IB < 60) was achieved in 20
(83.33%) cases.
In conclusion, the method of transluminal laser revascularization of
cerebral blood vessels was an effective one for the treatment of extensive
ischemic strokes and its effect was maintained for a long time; it caused
regression of mental, intellectual and motor disorders, promoted regression of
post-stroke dementia and significantly improved the quality of life, which
made it noticeably different from the conservative methods of treatment.
Article by Ivan
V. Maksimovich, from Clinic of Cardiovascular Diseases
named after Most Holy John Tobolsky, Moscow, Russia.
Full access: http://mrw.so/1v2C3n
Image
by Slickclic, from Flickr-cc.
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