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Transcatheter Technologies in Treating Brain Atherosclerosis Complicated by Chronic Cerebrovascular Insufficiency

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DOI: 10.4236/nm.2014.54019    2,738 Downloads   3,126 Views  

ABSTRACT

The research investigates the possibility of restoring the blood supply in patients with atherosclerosis of the brain, as well as the treatment of chronic cerebrovascular insufficiency. The research involves 946 patients aged 29 - 81 (average age 74) suffering from various types of cerebral atherosclerosis. 568 (60.04%) patients underwent transcatheter treatment—Test Group. 378 (39.96%) patients underwent conservative treatment—Control Group. The examination plan included laboratory diagnostics, assessment of dementia severity (CDR), assessment of cognitive impairment (MMSE), evaluation of the activities of daily living (IB), cerebral computed tomography (CT), cerebral magnetic resonance imaging (MRI), cerebral scintigraphy (SG), rheoencephalography (REG), cerebral multi-gated angiography (MUGA). To restore the blood supply, the method of transcatheter laser revascularization was applied; high-energy pulsed lasers were used for major intracranial arteries treatment, and low energy CW lasersfor distal intracranial branches treatment. Test Group: 459 (80.81%) patients had good clinical outcome, 91 (16.02%)satisfactory clinical outcome, 18 (3.17%)—relatively satisfactory clinical outcome; relatively positive clinical outcome was not obtained in any case. Control Group: good clinical outcome was not obtained in any case; 65 (17.20%) patients had satisfactory clinical outcome, 121 (23.26%)—relatively satisfactory clinical outcome, 192 (50.79%)—relatively positive clinical outcome. The method of transcatheter laser revascularization of cerebral vessels is a physiological, effective and low-invasive treatment for patients suffering from atherosclerosis of the brain. The obtained results last up to 10 years and more; it causes regression of mental and motor disorders, promotes regression of dementia and largely improves the patients’ quality of life; it has virtually no alternative—which makes the proposed method significantly different from conservative treatment methods.         

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Maksimovich, I. (2014) Transcatheter Technologies in Treating Brain Atherosclerosis Complicated by Chronic Cerebrovascular Insufficiency. Neuroscience and Medicine, 5, 161-176. doi: 10.4236/nm.2014.54019.

References

[1] Gillum, R.F., Kwagyan, J. and Obisesan, Th.O. (2011) Ethnic and Geographic Variation in Stroke Mortality Trends. Stroke, 42, 3294-3296.
http://dx.doi.org/10.1161/STROKEAHA.111.625343
[2] Maksimovich, I.V. (2012) Transcatheter Treatment of Atherosclerotic Lesions of the Brain Complicated by Vascular Dementia Development. World Journal of Neuroscience, 2, 200-209.
http://dx.doi.org/10.4236/wjns.2012.24031
[3] Frölich, A.M., Psychogios, N.M., Klotz, E., Knauth, M. and Knauth. P. (2012) Angiographic Reconstructions from Whole-Brain Perfusion CT for the Detection of Large Vessel Occlusion in Acute Stroke. Stroke, 43, 97-102.
http://dx.doi.org/10.1161/STROKEAHA.111.630954
[4] Abou-Chebl, A. (2013) Management of Acute Ischemic Stroke. Current Cardiology Reports, 15, 348-354.
http://dx.doi.org/10.1007/s11886-013-0348-4
[5] Gjulev, N.M., Pustozertsev, V.G. and Gjulev, S.N. (2002) Cerebrovascular Diseases. BINOM, Moscow.
http://www.combook.ru/product/158808/
[6] Qureshi, A.I. and Caplan, L.R. (1014) Intracranial Atherosclerosis. Lancet, 15, 984-998.
http://www.ncbi.nlm.nih.gov/pubmed/24007975
[7] Caplan, L.R., Thomas, A.J. and Inoa, V. (2014) Interventional Treatment of Brain Ischemia Related to Intracranial Cerebrovascular Occlusive Lesions. Current Opinion in Neurology, 27, 1-7.
http://dx.doi.org/10.1097/WCO.0000000000000044
[8] Pendlebury, S.T., Wadling, S., Silver, L.E. and Rothwell, P.M. (2011) Transient Cognitive Impairment in TIA and Minor Stroke. Stroke, 42, 3116-3121.
http://dx.doi.org/10.1161/STROKEAHA.111.621490
[9] Maksimovich, I.V. (2013) Possibilities of Transcatheter Treatment of Patients after Extensive Ischemic Stroke. World Journal of Neuroscience, 3, 171-185.
http://dx.doi.org/10.4236/wjns.2013.33022
[10] Klopfenstein, J.D., Ponce, F.A., Kim, L.J., Albuquerque, F.C., Nakaji, P. and Spetzler, R.F. (2005) Middle Cerebral Arterystenosis: Endovascular and Surgicaloptions. Skull Base, 15, 175-189.
http://dx.doi.org/10.1055/s-2005-871873
[11] Hashmi, J.T., Huang, Y.-Y., Osmani, B.Z., et al. (2010) Role of Low-Level Laser Therapy in Neurorehabilitation. PM & R, 2, S292-S305.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065857/
[12] Naeser, M.A. and Hamblin, M.R. (2011) Potential for Transcraniallaser or LED Therapy to Treat Stroke, Traumatic Brain Injury, and Neurodegenerative Disease. Photomedicine and Laser Surgery, 29, 443-446.
http://www.ncbi.nlm.nih.gov/pubmed/21728786
http://dx.doi.org/10.1089/pho.2011.9908
[13] Song, S., Zhou, F. and Chen, W.R. (2012) Low-Level Laser Therapy Regulates Microglial Function through Src-Mediated Signaling Pathways: Implications for Neurodegenerative Diseases. Journal of Neuroinflammation, 9, 219.
http://www.ncbi.nlm.nih.gov/pubmed/22989325
[14] Stephan, W., Banas, L.J., Bennett, M. and Tunceroglu, H. (2012) Efficacy of Super-Pulsed 905 NM Low Level Laser Therapy (LLLT) in the Management of Traumatic Brain Injury (TBI): A Case Study. World Journal of Neuroscience, 2, 231-233.
http://www.scirp.org/journal/PaperInformation.aspx?paperID=24793&#abstract
[15] Konstantinovic, L.M., Jelic, M.B., Jeremic, A., Stevanovic, V.B., Milanovic, S.D. and Filipovic, S.R. (2013) Transcranial Application of Near-Infrared Low-Level Laser Can Modulate Cortical Excitability. Lasers in Surgery and Medicine, 45, 648-653.
http://www.ncbi.nlm.nih.gov/pubmed/24136303
http://dx.doi.org/10.1002/lsm.22190
[16] Takaiwa, A., Kuwayama, N., Akioka, N., Kurosaki, K., et al. (2013) Effect of Carotid Endarterectomy on Cognitive Function in Patients with Asymptomatic Carotid Artery Stenosis. Acta Neurochirurgica, 155, 627-633.
http://link.springer.com/article/10.1007/s00701-013-1625-0
http://dx.doi.org/10.1007/s00701-013-1625-0
[17] Altinbas, A., Algra, A., Martin, M., Brown, M.M., et al. (2014) Effects of Carotid Endarterectomy or Stenting on Hemodynamic Complications in the International Carotid Stenting Study: A Randomized Comparison. International Journal of Stroke, 9, 284-290.
http://onlinelibrary.wiley.com/enhanced/doi/10.1111/ijs.12089/
[18] Muroi, C., Khan, N., Bellut, D., Fujioka, M. and Yonekawa, Y. (2011) Extracranial-Intracranial Bypass in Atherosclerotic Cerebrovascular Disease: Report of a Single Centre Experience. British Journal of Neurosurgery, 25, 357-362.
http://www.ncbi.nlm.nih.gov/pubmed/21501047
http://dx.doi.org/10.3109/02688697.2010.551673
[19] Papanagiotou, P., Roth, C., Walter, S., Behnke, S., Grunwald, L.Q., Viera, J., Politi, M., Körner, H., Kostopoulos, P., Haass, A., Fassbender, K. and Reith, W. (2011) Carotid Artery Stenting in Acute Stroke. Journal of the American College of Cardiology, 58, 2363-2369.
http://content.onlinejacc.org/article.aspx?articleid=1147802
http://dx.doi.org/10.1016/j.jacc.2011.08.044
[20] Matsumaru, Y., Tsuruta, W., Takigawa, T., Hyodo, A., Sato, H. and Matsumura, A. (2004) Percutaneous Transluminal Angioplasty for Atherosclerotic Stenoses of Intracranial Vessels. Interventional Neuroradiology, 10, 17-20.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3522214/
[21] Derdeyn, C.P. and Chimowitz, M.I. (2007) Angioplasty and Stenting for Atherosclerotic Intracranial Stenosis: Rationale for a Randomized Clinical Trial. Neuroimaging Clinics of North America, 17, 355-ix.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2040119/
[22] Dorn, F., Prothmann, S., Wunderlich, S. and Liebig, T. (2012) Stent Angioplasty of Intracranial Stenosis: Single Center Experience of 54 Cases. Clinical Neuroradiology, 22, 149-156.
http://www.ncbi.nlm.nih.gov/pubmed/?term=Dorn+F%2C+Prothmann+S%2C+Wunderlich+S%2C+Liebig+T http://dx.doi.org/10.1007/s00062-011-0106-1
[23] El Ali, A., Doeppner, T.R. and Hermann, D.M. (2011) Increased Blood-Brain Barrier Permeability and Brain Edema after Focal Cerebral Ischemia Induced by Hyperlipidemia: Role of Lipid Peroxidation and Calpain-1/2, Matrix Metalloproteinase-2/9, and RhoA Overactivation. Stroke, 42, 3238-3244.
http://www.ncbi.nlm.nih.gov/pubmed/21836084
http://dx.doi.org/10.1161/STROKEAHA.111.615559
[24] Moustafa, R.R., Momjian-Mayor, I., Simon Jones, P., Morbelli, S., Day, D.J., Aigbirhio, F.I., Fryer, T.D., Warburton, E.A. and Baron, J.C. (2011) Microembolism versus Hemodynamic Impairment in Rosary-Like Deep Watershed Infarcts: A Combined Positron Emission Tomography and Transcranial Doppler Study. Stroke, 42, 3138-3143.
http://stroke.ahajournals.org/content/42/11/3138.abstract
http://dx.doi.org/10.1161/STROKEAHA.111.616334
[25] Maksimovich, I.V. (2006) Method for Carrying out Transluminal Laser-Induced Brain Revascularization in Atherosclerotic Injury Cases. RF Patent No. 2297861.
http://worldwide.espacenet.com/publicationDetails/biblio?II=3&ND=3&adjacent=true&locale=en_EP&FT=D&date=20070427&CC=RU&NR=2297861C1&KC=C1
[26] Maksimovich, I.V. (2006) Method of Transluminal Laser Revascularization of Cerebral Blood Vessels Having Atherosclerotic Lesions. US Patent No. 7490612.
http://www.patentlens.net/patentlens/patents.html?patnums=US_7490612&returnTo=patentnumber.html%3Fquery%3D% 2528US_7490612%2Bin
%2Bpublication_number%2529
[27] Morris, J.C. (1993) The Clinical Dementia Rating (CDR): Current Version and Scoring Rules. Neurology, 43, 2412-2414.
http://www.neurology.org/content/43/11/2412.2
http://dx.doi.org/10.1212/WNL.43.11.2412-a
[28] Folstein, M.F., Folstein, S.E. and McHugh, P.R. (1975) “Mini-Mental State”: A Practical Method for Grading the Cognitive State of Patients for the Clinician. Journal of Psychiatric Research, 12, 189-198.
http://www.journalofpsychiatricresearch.com/article/0022-3956(75)90026-6/abstract http://dx.doi.org/10.1016/0022-3956(75)90026-6
[29] Mahoney, F.I. and Barthel, D.M. (1965) Functional Evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61-65.
http://www.ncbi.nlm.nih.gov/pubmed/14258950
[30] Maksimovich, I.V. (2013) Transcatheter Treatment of Patients after Extensive Ischemic Stroke. Journal of the American College of Cardiology, 62, B155-B156.
http://content.onlinejacc.org/article.aspx?articleid=1759823
[31] Deviatkov, N.D., Rabkin, I.Kh., Maksimovich, I.V., Rogov, R.A. and Aleinikov, V.S. (1986) Use of Copper-Vapor Laser Radiation for the Evaporation of Atherosclerotic Lesions of the Major Arteries in Vitro. Surgery, 4, 116-121.
http://www.ncbi.nlm.nih.gov/pubmed/3713043
[32] Petrovskiy, B.V., Deviatkov, N.D., Rabkin, I.Kh., Maksimovich, I.V. and Rogov, K.A. (1986) Destruction of Arteriosclerotic Lesions of Human Cadaveric Arteries by Laser Irradiation with Copper Vapors. Surgery, 5, 112-116.
http://www.ncbi.nlm.nih.gov/pubmed/3723942
[33] Kuleshov, E.V. and Maksimovich, I.V. (1994) Endovascular Surgery in Patients over 65 with Disseminated Atherosclerosis of the Vessels of the Pelvis and Lower Extremities. Vestnik Surgery Imeni I. I. Grekova, 152, 27-30.
http://www.ncbi.nlm.nih.gov/pubmed/7701734
[34] Maksimovich, I.V. (2004) Transljuminal Laser Angioplasty in Treatment of Ischemic Lesions of a Brain. M.D. Dissertation, Russian University of Friendship of the People, Moscow.
http://disseng.com/page/order/id/206426.html
[35] Chizhov, G.K., Kovalskaia, N.I. and Kozlov, V.I. (1991) The Effect of Helium-Neon Laser Radiation on the Energy Metabolic Indices of the Myocardium. Bulletin of Experimental Biology and Medicine, 111, 302-305.
http://www.ncbi.nlm.nih.gov/pubmed/2054512
http://dx.doi.org/10.1007/BF00840904
[36] Kozlov, V.I. and Azizov, G.A. (2007) Pathophysiological Characteristics of Microcirculatory Disorders in Chronic Arterial Ischaemia of Lower Limbs. Angiology and Vascular Surgery, 13, 17-23.
http://www.ncbi.nlm.nih.gov/pubmed/17679971
[37] Moskvin, S.V. (2008) System Analysis of Efficiency in Controlling Biological Systems with Low-Energy Laser Radiation. Doctor Thesis, Tula.
http://www.dissers.info/disser_323120.html
[38] Mak, M.C. and Cheing, G.L. (2012) Immediate Effects of Monochromatic Infrared Energy on Microcirculation in Healthy Subjects. Photomedicine and Laser Surgery, 30, 193-199.
http://europepmc.org/abstract/MED/22220935
http://dx.doi.org/10.1089/pho.2011.3012
[39] Barrett, D.W. and Gonzalez-Lima, F. (2013) Transcranial Infrared Laser Stimulation Produces Beneficial Cognitive and Emotional Effects in Humans. Neuroscience, 230, 13-23.
http://www.ncbi.nlm.nih.gov/pubmed/23200785
http://dx.doi.org/10.1016/j.neuroscience.2012.11.016
[40] Yang, X., Askarova, S., Sheng, W., et al. (2010) Low Energy Laser Light (632.8 NM) Suppresses Amyloid-β Peptide-Induced Oxidative and Inflammatory Responses in Astrocytes. Neuroscience, 171, 859-868.
http://www.sciencedirect.com/science/article/pii/S030645221001273X?np=y
[41] Starck, T., Nissilä, J., Aunio, A., Abou-Elseoud, A., Remes, J., Nikkinen, J., Timonen, M., Takala, T., Tervonen, O. and Kiviniemi, V. (2012) Stimulating Brain Tissue with Bright Light Alters Functional Connectivity in Brain at the Resting State. World Journal of Neuroscience, 2, 81-90.
http://www.scirp.org/journal/PaperInformation.aspx?paperID=19417&#abstract
[42] Heinrich, C., Blum, R., Gascón, S., et al. (2010) Directing Astroglia from the Cerebral Cortex into Subtype Specific Functional Neurons. PLoS Biology, 8, e1000373.
http://www.ncbi.nlm.nih.gov/pubmed/20502524
http://dx.doi.org/10.1371/journal.pbio.1000373

  
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