脳障害と治療

概要

Transcatheter Cerebral Revascularization in the Treatment of Atherosclerotic Lesions of the Brain

Ivan V Maksimovich

Background: The research investigates cerebral blood supply recovery be means of transcatheter laser revascularization in patients with advanced brain atherosclerosis. Materials and Methods: 974 patients aged 29-81 (mean age 74) with various types of cerebral atherosclerosis. Transcatheter treatment was performed in 594 (60.99%) cases-Test Group. Conservative treatment was performed in 380 (39.01%) cases-Control Group. Examination plan: CDR, MMSE, IB evaluation, cerebral SG, REG, CT, MRI, MRA, MUGA. High-energy lasers were used for main intracranial arteries revascularization; low-energy lasers-for intracranial distal branches revascularization. Results: Treatment results were studied in the early period (2-6 months) and in 2-10 years. Test Group: 478 (80.47%) patients showed good clinical outcome, 234 (48.95%) of them were re-examined: results persisted in 217 (92.73%), satisfactory outcome was observed in 17 (7.27%). Satisfactory clinical outcome-96 (16.16%) patients, 55 (57.29%) reexamined: results persisted in 50 (90.91%), relatively satisfactory outcome-in 5 (9.09%). Relatively satisfactory clinical outcome-20 (3.37%), re-examined 10 (50.00%): results persisted in 8 (80.00%), relatively positive outcome-2 (20.00%). Control Group: good clinical outcome was not obtained. Satisfactory clinical outcome was obtained in 65 (17.11%), 37 (56.92%) were re-examined: results persisted in 14 (37.84%), relatively satisfactory outcome-in 23 (62.15%). Relatively satisfactory clinical outcome was obtained in 122 (32.11%), re-examined 75 (61.48%): results persisted in 34 (45.33%), relatively positive outcome-in 41 (54.67%). Relatively positive outcome was obtained in 193 (50.78%), re-examined 86 (44.56%): results persisted in 40 (46.51%), worsened condition was detected in 46 (53.49%). Conclusions: The method of transcatheter laser revascularization of cerebral vessels is physiological, effective and of small traumatism; it stimulates natural angiogenesis, collateral, capillary revascularization and mental and motor disorders regression. The effect persists up to 10 years, which makes the method significantly different from conservative treatment.