Role of Magnetic Resonance Spectroscopy in Evaluation of Cerebral Metabolic Status Before and After Carotid Endarterectomy/Thromboendarterectomy and Carotid Artery Stenting in Patients with Asymptomatic Critical Internal Carotid Artery Stenosis

Stenting for elderly patients with internal carotid artery stenosis: analysis of clinical efficacy

OBJECTIVE

This retrospective study aimed to investigate the clinical efficacy and safety of carotid artery stenting (CAS) in elderly patients with internal carotid artery stenosis (ICS).

METHODS

Ninety elderly ICS patients admitted between January 2019 - July 2021 were selected and divided into a control group and a research group according to different treatment method. The 42 cases in the control group were received carotid endarterectomy and the 48 cases in the research group were treated with CAS. The effects of the two intervention methods on the National Institutes of Health Stroke Scale (NIHSS) score, complication rate, oxidative stress, inflammatory cytokines and cognitive function were observed and evaluated.

RESULTS

Compared to baseline (before treatment), the research group showed significantly reduced scores of NIHSS and activities of daily living, appreciably decreased levels of malonaldehyde, interleukin-6 and high-sensitivity C-reactive-protein, but increased superoxide dismutase, Rapid Verbal Retrieve score and Digit Span Test score after treatment. Also, the same trends were found when comparing the above results with those of the control group after treatment. The two groups showed a comparable complication rate.

CONCLUSIONS

The above data indicate a definite clinical efficacy and a favorable safety profile of CAS for ICS in the elderly. CAS can effectively reduce the oxidative stress and inflammatory cytokines of patients and enhance their cognitive function.

Correlation between Selection of Time Window for Acute Cerebral Infarction and Efficacy of Intravascular Stent Implantation

Objective. To explore the correlation between selection of time window for acute cerebral infarction (ACI) and efficacy of intravascular stent implantation. Methods. The clinical data of 84 ACI patients treated in our hospital from March 2019 to March 2020 were selected for the retrospective analysis, all study subjects received intravascular stent implantation, and after discharge, patients were assessed by the Modified Rankin Scale (mRS) and divided into the good prognosis group (n = 46, mRS score ≤2 points) and poor prognosis group (n = 38, mRS score >2 points). The clinical data of patients in the two groups at admission underwent univariate analysis, the indicators presenting $P$  < 0.05 were included in the logistic regression model, and the correlation between patients’ treatment time window and clinical effect was analyzed by multivariate logistic regression analysis and linear fitting analysis. Results. According to the multivariate logistic regression analysis, low-density lipoprotein (LDL), time window, and blood glucose level before treatment were the independent factors affecting patients’ treatment effect and were associated with the efficacy of intravascular stent implantation (r was 0.790, 0.889, and 0.672, respectively). Conclusion. LDL, time window, and blood glucose level before treatment are the important factors affecting the efficacy of intravascular stent implantation for ACI patients, among which the time window is most significantly associated with the clinical effect. Therefore, ACI patients should accept clinical treatment as early as possible.