Transcatheter Technologies in Treating Brain Atherosclerosis Complicated by Chronic Cerebrovascular Insufficiency

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 lasers — for distal intracranial branches treatment. Test Group: 459 (80.81%) patients had good clinical outcome, 91 (16.02%) — satisfac tory 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.