血管内超声在1例颈内动脉闭塞患者介入治疗中的应用

发布时间：2018-03-19 10:34

本文选题：颈内动脉闭塞　切入点：血管内超声　出处：《介入放射学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的探讨血管内超声(IVUS)技术在颈内动脉闭塞经皮腔内血管成形术(PTA)中的应用价值。方法 1例患者CTA明确颈内动脉闭塞,脑灌注成像见低灌注区与缺血相关症状符合,在IVUS导引下接受PTA治疗。采用微导丝及微导管同轴技术通过闭塞段,IVUS确认位于真腔内,微导管造影确认闭塞远端血管通畅,调整后放置栓塞保护器;IVUS测评斑块及管腔情况,球囊预扩张后再次测评;血管内恢复正向血流后通过IVUS虚拟组织学序列分析斑块稳定性,斑块纤维帽稳定且管腔狭窄率40%仅作单纯球囊扩张治疗。结果单纯球囊扩张治疗后闭塞血管再通,恢复正向血流。IVUS全程检测狭窄段斑块纤维帽稳定,管腔狭窄率40%,脑灌注成像显示低灌注状态明显改善。结论 IVUS技术在PTA治疗颈内动脉闭塞中起重要导引作用,可增加再通手术成功率,降低并发症发生率。
[Abstract]:Objective to evaluate the value of intravascular ultrasound (IVUS) in percutaneous transluminal angioplasty (CTA) of internal carotid artery occlusion (ICA). Under the guidance of IVUS, PTA was treated with microconductive wire and microcatheter coaxial technique. Microcatheter angiography was used to confirm the patency of distal occluded vessels, and the plaque and lumen were evaluated by microcatheterization with embolization protector. After balloon dilatation, the plaque stability was analyzed by IVUS virtual histological sequence. The plaque fibrous cap was stable and the stenosis rate of lumen was only treated by balloon dilatation. Results after the treatment of balloon dilatation, the occluded vessel was recanalized, and the positive blood flow was recovered. IVUS was used to detect the stability of the stenosis plaque fiber cap in the whole course. ConclusionThe IVUS technique plays an important guiding role in the treatment of internal carotid artery occlusion by PTA, which can increase the success rate of recanalization and reduce the incidence of complications.
【作者单位】：天津市西青医院神经外科;
【分类号】：R743

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