A retrospective study of interventional therapy of non-responsibility vessels in multiple extracranial and intracranial vascular stenosis in Xuanwu Hospital,investigate the efficacy, safety and feasibility of the methods.

During 2006 to 2010, the patients with multiple extracranial and intracranial vascular stenosis, treated with interventional therapy of non-responsibility vessels, were admitted in Xuanwu Hospital, Capital Medical University. Sixty-four patients were followed up (more than 1 year). Analyze the improvement of preoperative and postoperative ischemic symptom. To the patients with the neurological deficits, we do the NIHSS score. To the patients without the neurological deficits, we do the GES score. The method was as follows. (1)Depending on whether there were the neurological deficits, the patients were cultured into 2 groups to compare the data of preoperative and postoperation. (2)Depending on the relationship between responsibility vessels and non-responsibility vessels, the patients were cultured into 3 groups, anterior-posterior-circulation group, right and left internal carotid artery group, external and internal carotid artery groups. And then in the each group, the patients were grouped into 3 subgroups according to the degree of neurological deficits. (3)Compare the disparity of therapeutic effect between anterior--posterior-circulation and right and left internal carotid artery groups.

Among 64 cases of this group, 1 patient with R-ICA obstruction and R-ECA severe stenosis after the interventional therapy,whose swirl disappeared and vision of the right eye recovered apartly.In the other 63 cases, 21 patients with neurological deficits, 36 patients with no neurological deficits but only with TIA, the clinical effect is significant (P=0.000).In 42 patients of the anterior-circulation and posterior-circulation group (25 patients with NIHSS score=0, 17 patients with NIHSS score≠0),the effect is also significant(P=0.000). In 21 patients of right and left internal carotid artery group(11 patients with NIHSS score=0, 10 patients with NIHSS score≠0), the clinical symptom is recovered significantly (P<0.01) . Follow up data showed clinical stabilization in 1 of vertebral artery post-stenting. All the patients with the neurological deficits were recovered partly, without TIA. There were no complications.

Theoretically,there are many transcranial anastomoses between extracranial and intracranial vascular, and the ischemia could be compensated by vessels anastomoses. Clinical studies have shown that non-responsible vessels stenting can indeedly improve the symptoms.The non-responsible vessels stenting is a relative safe and effective method. There is no obvious difference between the compensate effect of anterior communicating artery and posterior communicating artery as vessels anastomoses. Therefore, to the patients with multiple extracranial and intracranial vascular stenosis not to do interventional therapy of responsibility vessels, we can do interventional therapy of non-responsibility vessels to compensate the blood supply of the culprit lesion through vessels anastomoses, to improve the symptom.