Symptomatic intracranial arteries atherosclerotic stenosis
Conditions
Interventions
surgical group:STA-MCA bypass
Sponsors
The Third Affiliated Hospital of Sun Yat-Sen University
Eligibility
Sex/Gender
All
Age
18 Years to 75 Years
Inclusion criteria
Inclusion criteria: 1. Patients can cooperate with the examination and follow-up on the premise of knowing the research contents, and sign the informed consent completely voluntarily; 2. Aged >= 18, 50%) were intracranial large vessels, including intracranial segment of internal carotid artery and M1 segment of middle cerebral artery. No adequate collateral circulation.No moyamoya disease (MMD); The ipsilateral superficial temporal artery shows clearly in CTA. At least one radial artery is negative in Allen test; 4. The patient has symptoms of cerebral ischemia caused by vascular lesions, including ischemic stroke: cerebral blood supply disorders caused by various causes ,which lead to cerebral ischemia, hypoxia-deficient necrosis of brain, and corresponding neurological defects; Transient ischemic attack; 5. Patient's syptom is due to atherosclerosis; 6. NHISS score < 9; 7. Modified Rankin scale score mRs <= 3 points; 8. Have at least one risk factor for atherosclerosis: hypertension, diabetes, hyperlipidemia and hyperhomocysteemia, or a history of smoking, family history of atherosclerosis ; 9. CTP showed decreased cerebral blood perfusion in the vascular supply area of stenosis, such as decreased CBF, increased or decreased CBV, prolonged MTT and prolonged TTP, and insufficient collateral circulation compensation.
Exclusion criteria
Exclusion criteria: 1. Acute ischemic stroke occurred within 4 weeks, which was confirmed by clinical symptoms or CTA or DSA images; Or a large area of cerebral infarction with a diameter of >5mm in the stenosis related area; 2. Stroke caused by occlusion of the perforating artery confirmed by medical imaging; 3. Patients with severe systemic diseases, such as severe diabetes, coronary heart disease, blood system diseases, etc. 4. Patients with a previous history of atrial fibrillation, infective endocarditis or rheumatic endocarditis, and with left atrial mural thrombosis and/or mitral and aortic valve vegetations confirmed by echocardiography; 5. Patients with stenosis or occlusion of large intracranial vessels (vertebral artery and basilar artery,> 50%); Patients with major arteries (common carotid artery, descending aorta etc.) of atherosclerotic plaque formation confirmed by vascular ultrasound and angiography, with the risk of detachment; 6. Patients' intracranial arterial stenosis wasn't caused by atherosclerotic, including: artery dissection, Moyamoya disease, vasculitis, herpes zoster, varicella zoster disease or other viral vascular disease and nerve syphilis, any other intracranial infection, associated with pleocytosis any intracranial stenosis, vascular lesions induced by radiation, muscular fiber dysplasia, sickle cell disease, neurofibromatosis, benign vascular disease of the central nervous system, postnatal vascular disease, suspected of vasospasm, suspicious embolus recanalization; 7. Cardiogenic stroke or potential cardiogenic thrombosis; 8. Any cerebral parenchyma or other intracranial subarachnoid space, subdural or epidural exudation within 4 weeks; 9. Myocardial infarction within 4 weeks; 10. History of bleeding within 4 weeks; 11. Patients who have undergone major surgery within 4 weeks; 12. Patients who are accompanied by intracranial tumors, aneurysms or arteriovenous malformations; 13. Patients who have allergies to experimental and surgical drugs (heparin, contrast agents, aspirin and clopidogrel, etc.) or operating devices, or allergic constitution; or patients can't take the above-mentioned drugs; 14. Patients cannot take general anesthesia; 15. Women who are pregnant or breastfeeding, or who plan to become pregnant within one year; 16. Patients' Hemoglobin 400mg/dl (22.2mmol/L); Genetic or acquired hemorrhagic constitution, lack of anticoagulant factors; Or had received anticoagulant therapy before randomization and INR> was 1.7. 17. Patients restenosis after intracranial arterioplasty; 18. Patients with poor general condition, estimated survival time < 3 years; 19. Patients' Follow-up is not expected to be completed; Or patients are participating in other clinical trials.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| cerebral blood perfusion; | — |
Countries
China
Contacts
Public ContactWang Hui
Department of Neurosurgery, the Third Affiliated Hospital, Sun Yat-Sen University
Outcome results
None listed