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  1 / 2995 MEDLINE  
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[PMID]:29390369
[Au] Autor:Li X; Liu M; Zhang Y; Li Z; Wang D; Yan X
[Ad] Endereço:Guangzhou University of Chinese Medicine.
[Ti] Título:Acupuncture for vertebrobasilar insufficiency vertigo: Protocol for a systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);96(50):e9261, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Vertebrobasilar insufficiency vertebrobasilar (VBIV) is a serious nerve disease and many old people suffer from it. Acupuncture has been widely applied in the treatment of VBIV. However, to our knowledge, there has been no systematic review or meta-analysis of randomized controlled trails regarding the effectiveness of this treatment. Here, we provide a protocol to evaluate the effectiveness and safety of acupuncture for VBIV. METHODS: Relevant randomized controlled trials in 5 databases (EMBASE, PubMed, the Cochrane Central Register of Controlled Trials [Cochrane Library], Chinese Biomedical Literature Database [CBM], China National Knowledge Infrastructure [CNKI]) will be comprehensively searched by 2 researchers in December 2017. The clinical efficacy will be accepted as the primary outcomes. We will also use RevMan V.5.3 software to compute the data synthesis carefully when a meta-analysis is allowed. RESULTS: This study will provide a high-quality synthesis of current evidence of acupuncture for VBIV from several aspects including clinical efficacy, the blood flow velocity of the left vertebral artery (LVA), the right vertebral artery (RVA), the basilar artery (BA)and adverse events. CONCLUSION: The conclusion of our systematic review will provide evidence to judge whether acupuncture is an effective and safety intervention for patient with VBIV.
[Mh] Termos MeSH primário: Terapia por Acupuntura/métodos
Projetos de Pesquisa
Insuficiência Vertebrobasilar/terapia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009261


  2 / 2995 MEDLINE  
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[PMID]:29213030
[Au] Autor:Alabri H; Lewis WD; Manjila S; Alkhachroum AM; De Georgia MA
[Ad] Endereço:Cleveland Medical Center, Case Western Reserve University, Cleveland, OH, USA.
[Ti] Título:Acute Bilateral Ophthalmoplegia Due to Vertebrobasilar Dolichoectasia: A Report of Two Cases.
[So] Source:Am J Case Rep;18:1302-1308, 2017 Dec 07.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND Vertebrobasilar dolichoectasia (VBD) is a complex progressive arterial disease characterized by dilation, elongation, and tortuosity of the vertebral and basilar arteries, and may be congenital or acquired. VBD may lead to progressive compression of the brainstem, cranial nerve abnormalities, and intracranial hemorrhage, but may also be associated with arterial thrombosis, with ischemic stroke as the most common clinical outcome. CASE REPORT Two cases of VBD are presented, both with acute bilateral ophthalmoplegia and cranial nerve palsies, and vertebrobasilar arterial thrombosis that resulted in ischemic stroke. CONCLUSIONS VBD is a complex arterial disease with a variety of clinical manifestation, with bilateral ophthalmoplegia being a rare presentation. Clinical management of VBD is a challenge as there are no current management guidelines. Therefore, clinical management of cases of VBD should be individualized to balance the risks and benefits of treatment options for each patient.
[Mh] Termos MeSH primário: Infarto Encefálico/etiologia
Trombose Intracraniana/etiologia
Oftalmoplegia/etiologia
Insuficiência Vertebrobasilar/complicações
[Mh] Termos MeSH secundário: Doença Aguda
Idoso
Infarto Encefálico/diagnóstico por imagem
Doenças dos Nervos Cranianos/etiologia
Feminino
Seres Humanos
Trombose Intracraniana/diagnóstico por imagem
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171208
[St] Status:MEDLINE


  3 / 2995 MEDLINE  
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[PMID]:29095279
[Au] Autor:Yang F; Yue H; Wu L; Qin X; Shi L; Qu W
[Ad] Endereço:aDepartment of Neurology bDepartment of Public Health, Rizhao People's Hospital, Rizhao, China.
[Ti] Título:Ischemic stroke due to intracranial arterial dolichoectasia coexisting with spontaneous dissection of the basilar artery: A case report.
[So] Source:Medicine (Baltimore);96(44):e8422, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: We present a rarely seen case of cerebral infarction due to intracranial dolichoectasia coexisting with spontaneous dissection of the basilar artery. A definition of dolichoectasia, its pathology, and imaging findings, as well as the clinical management and prognosis are briefly reviewed. CONCLUSION: We discuss in general terms the diagnosis of basilar artery dissection and its probable relationship with the occurrence of dolichoectasia.
[Mh] Termos MeSH primário: Artéria Basilar
Infarto Cerebral/etiologia
Doenças Arteriais Intracranianas/complicações
Dissecação da Artéria Vertebral/complicações
Insuficiência Vertebrobasilar/complicações
[Mh] Termos MeSH secundário: Seres Humanos
Masculino
Meia-Idade
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171103
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008422


  4 / 2995 MEDLINE  
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[PMID]:29020008
[Au] Autor:Yum KS; Chang JY; Jeong WJ; Lee S; Jeong JH; Yeo MJ; Hong JH; Park HK; Chung I; Kim BJ; Bang JS; Bae HJ; Han MK
[Ad] Endereço:Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
[Ti] Título:Effect of statin on progression of symptomatic basilar artery stenosis and subsequent ischemic stroke.
[So] Source:PLoS One;12(10):e0183798, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND OBJECTIVE: Symptomatic basilar artery stenosis (BAS) is associated with high risk of ischemic stroke recurrence. We aimed to investigate whether statin therapy might prevent the progression of symptomatic BAS and stroke recurrence. METHODS: We retrospectively analyzed the data of patients with acute ischemia with symptomatic BAS, which was assessed using magnetic resonance angiogram (MRA) imaging on admission day, and 1 year later (or the day of the clinical event). The clinical endpoints were recurrent ischemic stroke and its composites, transient ischemic attack, coronary disease, and vascular death. RESULTS: Of the 153 patients with symptomatic BAS, 114 (74.5%) were treated with a statin after experiencing a stroke. Statin therapy significantly prevented the progression of symptomatic BAS (7.0% vs 28.2%) and induced regression (22.8% vs 15.4%) compared to non-statin users (p = 0.002). There were 31 ischemic stroke incidences and 38 composite vascular events. Statin users showed significantly lower stroke recurrence (14.9% vs 35.9%, p = 0.05) and composite vascular events (17.5% vs 46.2%; odds ratio [OR], 0.29; 95% confidence interval [CI], 0.13-0.64) than those not using statins did. Recurrent stroke in the basilar territory and composite vascular events were more common in patients with progression of BAS than they were in other patients (OR, 5.16; 95% CI, 1.63-16.25 vs OR, 4.2; 95% CI, 1.56-11.34). CONCLUSION: Our study suggests that statin therapy may prevent the progression of symptomatic BAS and decrease the risk of subsequent ischemic stroke. Large randomized trials are needed to confirm this result.
[Mh] Termos MeSH primário: Isquemia Encefálica/etiologia
Progressão da Doença
Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico
Acidente Vascular Cerebral/tratamento farmacológico
Acidente Vascular Cerebral/etiologia
Insuficiência Vertebrobasilar/tratamento farmacológico
Insuficiência Vertebrobasilar/patologia
[Mh] Termos MeSH secundário: Idoso
Isquemia Encefálica/tratamento farmacológico
Feminino
Seguimentos
Seres Humanos
Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia
Imagem Tridimensional
Angiografia por Ressonância Magnética
Masculino
Resultado do Tratamento
Insuficiência Vertebrobasilar/complicações
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171012
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0183798


  5 / 2995 MEDLINE  
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[PMID]:28835400
[Au] Autor:Markus HS; Larsson SC; Kuker W; Schulz UG; Ford I; Rothwell PM; Clifton A; VIST Investigators
[Ad] Endereço:From the Stroke Research Group (H.S.M., S.C.L.), Department of Clinical Neurosciences, University of Cambridge, Cambridge Biomedical Campus; Nuffield Department of Clinical Neurosciences (W.K., U.G.S., P.M.R.), John Radcliffe Hospital, University of Oxford; Robertson Centre for Biostatistics (I.F.),
[Ti] Título:Stenting for symptomatic vertebral artery stenosis: The Vertebral Artery Ischaemia Stenting Trial.
[So] Source:Neurology;89(12):1229-1236, 2017 Sep 19.
[Is] ISSN:1526-632X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare in the Vertebral Artery Ischaemia Stenting Trial (VIST) the risks and benefits of vertebral angioplasty and stenting with best medical treatment (BMT) alone for symptomatic vertebral artery stenosis. METHODS: VIST was a prospective, randomized, open-blinded endpoint clinical trial performed in 14 hospitals in the United Kingdom. Participants with symptomatic vertebral stenosis ≥50% were randomly assigned (1:1) to vertebral angioplasty/stenting plus BMT or to BMT alone with randomization stratified by site of stenosis (extracranial vs intracranial). Because of slow recruitment and cessation of funding, recruitment was stopped after 182 participants. Follow-up was a minimum of ≥1 year for each participant. RESULTS: Three patients did not contribute any follow-up data and were excluded, leaving 91 patients in the stent group and 88 in the medical group. Mean follow-up was 3.5 (interquartile range 2.1-4.7) years. Of 61 patients who were stented, stenosis was extracranial in 48 (78.7%) and intracranial in 13 (21.3%). No periprocedural complications occurred with extracranial stenting; 2 strokes occurred during intracranial stenting. The primary endpoint of fatal or nonfatal stroke occurred in 5 patients in the stent group vs 12 in the medical group (hazard ratio 0.40, 95% confidence interval 0.14-1.13, = 0.08), with an absolute risk reduction of 25 strokes per 1,000 person-years. The hazard ratio for stroke or TIA was 0.50 ( = 0.05). CONCLUSIONS: Stenting in extracranial stenosis appears safe with low complication rates. Large phase 3 trials are required to determine whether stenting reduces stroke risk. ISRCTNCOM IDENTIFIER: ISRCTN95212240. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with symptomatic vertebral stenosis, angioplasty with stenting does not reduce the risk of stroke. However, the study lacked the precision to exclude a benefit from stenting.
[Mh] Termos MeSH primário: Angioplastia/métodos
Fármacos Hematológicos/uso terapêutico
Avaliação de Resultados (Cuidados de Saúde)
Intervenção Coronária Percutânea/métodos
Stents
Insuficiência Vertebrobasilar/terapia
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Angioplastia/efeitos adversos
Feminino
Seguimentos
Seres Humanos
Ataque Isquêmico Transitório/etiologia
Masculino
Meia-Idade
Intervenção Coronária Percutânea/efeitos adversos
Método Simples-Cego
Acidente Vascular Cerebral/etiologia
Insuficiência Vertebrobasilar/complicações
Insuficiência Vertebrobasilar/tratamento farmacológico
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Hematologic Agents)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170825
[St] Status:MEDLINE
[do] DOI:10.1212/WNL.0000000000004385


  6 / 2995 MEDLINE  
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[PMID]:28754833
[Au] Autor:Thijs V; Grittner U; Fazekas F; McCabe DJH; Giese AK; Kessler C; Martus P; Norrving B; Ringelstein EB; Schmidt R; Tanislav C; Putaala J; Tatlisumak T; von Sarnowski B; Rolfs A; Enzinger C; Stroke in Fabry (SIFAP1) Investigators
[Ad] Endereço:From the Stroke Division, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Heidelberg, Victoria, Australia (V.T.); Department of Neurology, Austin Health, Heidelberg, Victoria, Australia (V.T.); Center for Stroke Research and Department of Biostatistics and Clinical Epide
[Ti] Título:Dolichoectasia and Small Vessel Disease in Young Patients With Transient Ischemic Attack and Stroke.
[So] Source:Stroke;48(9):2361-2367, 2017 Sep.
[Is] ISSN:1524-4628
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND PURPOSE: We evaluated whether basilar dolichoectasia is associated with markers of cerebral small vessel disease in younger transient ischemic attack and ischemic stroke patients. METHODS: We used data from the SIFAP1 study (Stroke in Young Fabry Patients), a large prospective, hospital-based, screening study for Fabry disease in young (<55 years) transient ischemic attack/stroke patients in whom detailed clinical data and brain MRI were obtained, and stroke subtyping with TOAST classification (Trial of ORG 10172 in Acute Stroke Treatment) was performed. RESULTS: Dolichoectasia was found in 508 of 3850 (13.2%) of patients. Dolichoectasia was associated with older age (odds ratio per decade, 1.26; 95% confidence interval, 1.09-1.44), male sex (odds ratio, 1.96; 95% confidence interval, 1.59-2.42), and hypertension (odds ratio, 1.39; 95% confidence interval, 1.13-1.70). Dolichoectasia was more common in patients with small infarctions (33.9% versus 29.8% for acute lesions, =0.065; 29.1% versus 16.5% for old lesions, <0.001), infarct location in the brain stem (12.4% versus 6.9%, <0.001), and in white matter (27.8% versus 21.1%, =0.001). Microbleeds (16.3% versus 4.7%, =0.001), higher grades of white matter hyperintensities ( <0.001), and small vessel disease subtype (18.1% versus 12.4%, overall for differences in TOAST ( =0.018) were more often present in patients with dolichoectasia. CONCLUSIONS: Dolichoectasia is associated with imaging markers of small vessel disease and brain stem localization of acute and old infarcts in younger patients with transient ischemic attack and ischemic stroke. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00414583.
[Mh] Termos MeSH primário: Doenças de Pequenos Vasos Cerebrais/epidemiologia
Ataque Isquêmico Transitório/epidemiologia
Acidente Vascular Cerebral/epidemiologia
Insuficiência Vertebrobasilar/epidemiologia
[Mh] Termos MeSH secundário: Adulto
Fatores Etários
Infartos do Tronco Encefálico/epidemiologia
Hemorragia Cerebral/epidemiologia
Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem
Feminino
Seres Humanos
Hipertensão/epidemiologia
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Razão de Chances
Fatores de Risco
Fatores Sexuais
Insuficiência Vertebrobasilar/diagnóstico por imagem
Substância Branca/irrigação sanguínea
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170730
[St] Status:MEDLINE
[do] DOI:10.1161/STROKEAHA.117.017406


  7 / 2995 MEDLINE  
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[PMID]:28723788
[Au] Autor:Wang MY; Liu YS; Li K; Liu YJ; Wang F
[Ad] Endereço:Department of Intervention Therapy, First Affiliated Hospital of Dalian Medical University, Dalian, China.
[Ti] Título:Protective effect of the microcatheter placed at the normal vertebral artery in intracranial stent-assisted angioplasty for vertebral artery stenosis: A case report.
[So] Source:Medicine (Baltimore);96(29):e7569, 2017 Jul.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: A carefully designed intracranial stent-assisted angioplasty (SAA) is presented here that may prevent subsequent branch artery occlusion. PATIENT CONCERNS: A 72-year-old man with a 3-month history of progressive and intermittent vertigo without any obvious trigger, accompanied by nausea. DIAGNOSES: Intracranial atherosclerotic disease. INTERVENTIONS: the patient underwent intracranial SAA in accordance with the procedure described here. OUTCOMES: The patient's paroxysmal vertigo completely subsided, with no complications during the short-term follow-up. LESSONS: This novel intracranial SAA procedure is safe and may reduce the risk of subsequent artery occlusion.
[Mh] Termos MeSH primário: Angioplastia com Balão
Arteriosclerose Intracraniana/cirurgia
Stents
Artéria Vertebral/cirurgia
Insuficiência Vertebrobasilar/cirurgia
[Mh] Termos MeSH secundário: Idoso
Cateteres de Demora
Seres Humanos
Arteriosclerose Intracraniana/complicações
Arteriosclerose Intracraniana/diagnóstico
Arteriosclerose Intracraniana/tratamento farmacológico
Masculino
Artéria Vertebral/diagnóstico por imagem
Insuficiência Vertebrobasilar/complicações
Insuficiência Vertebrobasilar/diagnóstico
Insuficiência Vertebrobasilar/tratamento farmacológico
Vertigem/diagnóstico
Vertigem/tratamento farmacológico
Vertigem/etiologia
Vertigem/cirurgia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170808
[Lr] Data última revisão:
170808
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170721
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000007569


  8 / 2995 MEDLINE  
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[PMID]:28583457
[Au] Autor:Janjua MB; Ivasyk I; Greenfield JP
[Ad] Endereço:Department of Neurological Surgery, Weill Cornell Medical College And New York Presbyterian Hospital, New York, New York, USA. Electronic address: mburhanj@gmail.com.
[Ti] Título:Vertebrobasilar Insufficiency Due to Distal Posterior Inferior Cerebellar Artery Compression in Chiari 1.5.
[So] Source:World Neurosurg;104:1050.e1-1050.e6, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Chiari malformation is characterized by radiographic evidence of herniation of cerebellar tonsils below the foramen magnum and a symptom complex of headaches; breathing, swallowing, or sleep difficulties; ataxia; restless; and motor and/or sensory deficits. CASE DESCRIPTION: We report a case of a 34-year-old woman whose imaging indicated a Chiari 1.5 with brainstem (caudal medulla) herniation and an expansive cervical syrinx. Her symptom complex showed signs both of cervical syringomyelia, as well as ones localizable to the medulla. An intradural exploration revealed the occlusion and caudal displacement of the loop of the right posterior inferior cerebellar artery, which was later confirmed via magnetic resonance angiography. CONCLUSIONS: In the setting of severe Chiari malformations, particularly the Chiari 1.5 variant, assessment of the posterior fossa vasculature may be useful in defining a subset of patients with preoperative compromise in posterior fossa blood flow and postoperative expectations. Preoperative planning and exploration of midline dorsal brain stem along with the tonsilomedullary fissure could be helpful for contribution of vascular pathology among Chiari symptoms complex in these patients.
[Mh] Termos MeSH primário: Malformação de Arnold-Chiari/cirurgia
Cerebelo/irrigação sanguínea
Encefalocele/cirurgia
Siringomielia/cirurgia
Insuficiência Vertebrobasilar/cirurgia
[Mh] Termos MeSH secundário: Adulto
Malformação de Arnold-Chiari/complicações
Angiografia Cerebral
Descompressão Cirúrgica
Encefalocele/etiologia
Feminino
Seres Humanos
Angiografia por Ressonância Magnética
Bulbo
Procedimentos Neurocirúrgicos
Siringomielia/complicações
Insuficiência Vertebrobasilar/diagnóstico por imagem
Insuficiência Vertebrobasilar/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170607
[St] Status:MEDLINE


  9 / 2995 MEDLINE  
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[PMID]:28434468
[Au] Autor:Guo Z; Su Z; Wang Z; Luo X; Lai R
[Ad] Endereço:The Second Clinical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, China.
[Ti] Título:The effect of chinese herbal medicine Banxia Baizhu Tianma Decoction for the treatment of vertebrobasilar insufficiency vertigo: A systematic review and meta-analysis of randomized controlled trials.
[So] Source:Complement Ther Med;31:27-38, 2017 Apr.
[Is] ISSN:1873-6963
[Cp] País de publicação:Scotland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Banxia Baizhu Tianma Decoction (BBTD) is widely used to treat vertebrobasilar insufficiency vertigo (VBIV) in China, but its efficacy remains largely unexplored. We systemically summarized relevant evidence from randomized controlled trials (RCTs) to assess the therapeutic effect of BBTD. METHODS: Seven electronic databases were searched for relevant electronic studies published before July 2016. We evaluated RCTs that compared BBTD, anti-vertigo drugs and a combination of BBTD and anti-vertigo drugs. We performed a meta-analysis in accordance with the Cochrane Collaboration criteria. The outcomes were clinical efficacy (CE), blood flow velocity of the vertebrobasilar artery by transcranial Doppler (TCD), and adverse effects. RESULTS: Twenty-seven studies with a total of 2796 patients were identified. Compared with anti-vertigo drugs, BBTD showed slight effects on CE (n=350; RR, 1.09; 95% CI, 1.01-1.18; p=0.03; I =0%); however, BBTD plus anti-vertigo drugs (BPAD) significantly improved the clinical efficacy (n=2446; RR, 1.20; 95% CI, 1.16-1.24; p<0.00001; I =0%) and accelerated the blood flow velocity of the left vertebral artery (LVA) (n=1444; WMD, 5.21cm/s; 95% CI, 3.72-6.70cm/s; p<0.00001; I =91%), the blood flow velocity of the right vertebral artery (RVA) (n=1444; WMD, 5.45cm/s; 95% CI, 4.02-6.88cm/s; p<0.00001; I =89%), and the blood flow velocity of the basilar artery (BA) (n=1872; WMD, 5.20cm/s; 95% CI, 3.86-6.54cm/s; p<0.00001; I =90%). Adverse effects were mentioned in six studies. CONCLUSIONS: The current evidence indicates that BPAD is effective for the treatment of VBIV, but the efficacy and safety of BBTD is uncertain because of the limited number of trials and low methodological quality. Hence, high-quality and adequately powered RCTs are warranted.
[Mh] Termos MeSH primário: Medicamentos de Ervas Chinesas/uso terapêutico
Insuficiência Vertebrobasilar/tratamento farmacológico
Vertigem/tratamento farmacológico
[Mh] Termos MeSH secundário: Medicamentos de Ervas Chinesas/efeitos adversos
Seres Humanos
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Drugs, Chinese Herbal)
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170626
[Lr] Data última revisão:
170626
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170425
[St] Status:MEDLINE


  10 / 2995 MEDLINE  
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[PMID]:28427984
[Au] Autor:Wen WL; Li ZF; Zhang YW; Yang PF; Simfukwe K; Fang YB; Zhang TY; Deng BQ; Hong B; Liu JM; Huang QH
[Ad] Endereço:Department of Neurosurgery, Shanghai Changhai Hospital, Shanghai, China.
[Ti] Título:Effect of Baseline Characteristics on the Outcome of Stent Retriever-Based Thrombectomy in Acute Basilar Artery Occlusions: A Single-Center Experience and Pooled Data Analysis.
[So] Source:World Neurosurg;104:1-8, 2017 Aug.
[Is] ISSN:1878-8769
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To explore the association of baseline characteristics and the outcome of patients with acute basilar artery occlusion (BAO) after stent retriever-based thrombectomy (SRT). METHODS: Clinical and imaging information of consecutive SRT-treated patients with BAO from a comprehensive stroke center and up-to-date literature were reviewed respectively. The impact of baseline variables toward favorable outcome was evaluated using subgroup analysis and odds ratio (OR) extracted from published data together with single-center records using pooled analysis. RESULTS: Nineteen cases from our center and 15 published studies involving 487 cases were included. Estimated pooled favorable outcome rate was 0.3746 (95% confidence interval [CI], 0.3165-0.4327), mortality was 0.2950 (95% CI, 0.2390-0.3510). Pooled estimates showed that successful reperfusion (modified thrombolysis in cerebral ischemia scale 2b or 3) gained by SRT alone was 0.7317 (95% CI, 0.6532-0.8102) and final successful reperfusion rate with or without additional reperfusion procedures was 0.8834 (95% CI, 0.8279-0.9390). Univariate analysis indicated that patients with successful reperfusion (OR, 2.05; P = 0.05), distal segment occlusion (OR, 2.03; P = 0.03), and cardioembolus origin (OR, 2.13; P = 0.01) were more likely to have favorable outcome (modified Rankin Scale score ≤2 at 3 months). Study series that applied intra-arterial thrombolysis, angioplasty, or stenting as rescuing therapy had higher successful reperfusion rate but they did not show a higher rate of favorable outcome. CONCLUSIONS: SRT with or without additional treatment appeared to be effective for the treatment of BAO. Successful reperfusion, distal segment occlusion, and cardiac embolism were associated with favorable outcome. The overall benefit of lesions requiring additional reperfusion therapy was unclear.
[Mh] Termos MeSH primário: Remoção de Dispositivo/instrumentação
Remoção de Dispositivo/mortalidade
Complicações Pós-Operatórias/mortalidade
Trombectomia/instrumentação
Trombectomia/mortalidade
Insuficiência Vertebrobasilar/mortalidade
Insuficiência Vertebrobasilar/cirurgia
[Mh] Termos MeSH secundário: Doença Aguda
Adulto
Idoso
Idoso de 80 Anos ou mais
Remoção de Dispositivo/estatística & dados numéricos
Feminino
Seres Humanos
Masculino
Meia-Idade
Prevalência
Fatores de Risco
Stents
Taxa de Sobrevida
Trombectomia/estatística & dados numéricos
Resultado do Tratamento
Insuficiência Vertebrobasilar/diagnóstico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170925
[Lr] Data última revisão:
170925
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170422
[St] Status:MEDLINE



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