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BackgroundStroke is the leading cause of mortality in China, with limited evidence of in-hospital burden obtained from nationwide surveys. We aimed to monitor and track the temporal trends and rural-urban disparities in cerebrovascular risk factors, management and outcomes from 2005 to 2015.MethodsWe used a two-stage random sampling survey to create a nationally representative sample of patients admitted for ischaemic stroke in 2005, 2010 and 2015. We sampled participating hospitals with an economic-geographical region-stratified random-sampling approach first and then obtained patients with a systematic sampling approach. We weighed our survey data to estimate the national-level results and assess changes from 2005 to 2015.ResultsWe analysed 28 277 ischaemic stroke admissions from 189 participating hospitals. From 2005 to 2015, the estimated national hospital admission rate for ischaemic stroke per 100 000 people increased (from 75.9 to 402.7, Ptrend

Objective: To evaluate the relationship between vertebrobasilar ischemia (VBI) and sleep apnea hypopnea syndrome (SAHS) and the effect of percutaneous transluminal stenting for VBI on the clinical parameters of SAHS., Methods: Twenty patients with VBI were included for clinical history, physical examination with sleep quentionnaires and scored by the Epworth Sleepiness Scale (ESS). Polysomnographic (PSG) studies were performed before and after vascular stenting for VBI. The relationship among clinical factors, the incidence and characteristics of SAHS were analyzed. The changes of apnea hypopnea index (AHI), longest apnea duration (LAD), the total time of apnea and hypopnea (AH%), the lowest arterial saturation (LSaO(2)) and oxygen desaturation index (ODI(4)) before and after vascular stenting were compared., Results: PSG studies were performed in 20 cases of VBI. SAHS was confirmed in 17 of the 20 patients, including mild (10/20), moderate (3/20) and severe (4/20), all were of obstructive. Before stenting therapy, AHI was 11.3/h (6.3 - 23.6)/h, but was 5.0/h (1.6 - 12.7)/h after therapy. LAD was (31.5 +/- 18.6) s vs (19.5 +/- 12.4) s, LSaO2 was (83.6 +/- 7.1)% vs (86.1 +/- 3.3)%, the AH% was [2.3 (0.6% - 9.8)%] vs [6.9% (2.6 - 14.3)%], ODI(4) was 10.1/h (5.3 - 29.0)/h vs 5.8/h (2.7 - 17.0)/h, respectively before and after stenting. AHI, LAD and ODI(4) were significantly decreased and LSaO(2) was increased after stenting for VBI., Conclusion: This series of patients with cerebravascular ischemia caused by vertebrobasilar artery stenosis had a high prevalence of obstructive sleep apnea. Vertebrobasilar vascular stenting was shown to be a reliable method of decreasing the degree of sleep-disordered breathing and hypoxia for SAHS patients with vertebrobasilar artery stenosis.

Objective: To evaluate the safety, feasibility and long-term results of stent-assisted angioplasty in atherosclerotic ostial stenosis of vertebral artery (VA)., Methods: Forty one patients (48 lesions) with symptomatic cerebral ischemic events or stroke attributed to VA atherosclerotic ostial stenosis > or = 50% (NASCET method) found in digital subtraction angiography (DSA) were approached for consent to participate in the study. During the procedure, three cases used protection devices and three used drug-eluting stents., Results: Thirty seven of the patients were male and 4 female. Mean age was 63.4 years (range 36 - 80). Technical success was achieved in 97.9 % of the lesions. One suffered from a stroke that occurred within 30-days postprocedural. 37 patients were followed up for 22.4 months. The clinical follow-up outcomes showed that there were no lesion-related strokes and deaths, three appeared to have return of neurological symptoms (TIA). Among the 21 patients (26 lesions) who had angiography follow-up, re-stenosis (> or = 50%) was revealed in 9 patients (9 lesions) (34.6%). However, seven of these 9 patients remained asymptomatic., Conclusions: Stent-assisted angioplasty for atherosclerotic ostial stenosis of VA is safe and feasible. It can prevent the lesion-related stroke, death and TIA recurrence. However, further studies are needed to clarify how to reduce the relatively high re-stenosis rate.