Natural history of vertebrobasilar dolichoectasia
Natural history of vertebrobasilar dolichoectasia
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DOI：
10.1212/01.wnl.0000286947.89193.f3
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发表时间：
2008-01-01
期刊：
影响因子：
9.9
通讯作者：
Rossi, Simone
中科院分区：
文献类型：
--
作者：
Passero, Stefano G.;Rossi, Simone
目的：椎基底动脉延长扩张症（VBD）患者的长期预后尚不清楚。本研究的目的是探讨VBD的自然史，评估其进展，并检查可能影响临床过程的因素，这种conditions.Methods：我们进行了前瞻性的临床和影像学随访研究，156例连续VDB的平均11.7年。通过多变量分析评价事件的预测因素。生存分析被用来评估发病率。结果：在随访期间，93例（60%）经历了至少一个事件：75例中风（59缺血性和21出血性），31例患者有新的压迫症状，2例脑积水。事件与VBD的严重程度显著相关，即，直径、分叉高度和基底动脉的侧向位移。随访期间，43%的患者VBD进展。VBD的进展与较高的发病率和死亡率相关。5年时无不良健康事件的存活者累积比例为54.1，10年时为39.5，15年时为23.5。在随访期间，62例患者死亡，中风是最常见的死因。结论：椎基底动脉延长扩张症（VBD）患者的长期预后主要取决于病情的严重程度在诊断和其演变特征。VBD的进展使患者暴露于高风险的不良事件，尤其是卒中。
Objective: The long-term prognosis of patients with vertebrobasilar dolichoectasia (VBD) is unknown. The purpose of this study was to explore the natural history of VBD, evaluate its progression, and examine factors that may influence the clinical course of this condition.Methods: We conducted a prospective clinical and imaging follow-up study of 156 consecutive patients with VDB followed for an average of 11.7 years. Predictors of events were evaluated by multivariate analysis. Survival analysis was used to evaluate rates of incidence.Results: During follow-up, 93 patients (60%) experienced at least one event: 75 patients had stroke (59 ischemic and 21 hemorrhagic), 31 patients had new compressive symptoms, and 2 patients had hydrocephalus. Events were significantly associated with the severity of VBD, i.e., diameter, height of bifurcation, and lateral displacement of the basilar artery. During follow-up VBD progressed in 43% of patients. Progression of VBD was associated with a higher morbidity and mortality. The cumulative proportion of survivors free of adverse health event was 54.1 at 5 years, 39.5 at 10 years, and 23.5 at 15 years. During follow-up, 62 patients died and stroke was the most common cause of death.Conclusions: The long-term prognosis of patients with vertebrobasilar dolichoectasia (VBD) depended mainly on the severity of the condition at diagnosis and on its evolutionary characteristics. Progression of VBD exposed patients to high risk of adverse events, especially stroke.