导丝留置技术在急性脑动脉闭塞机械取栓中的应用

发布时间：2018-04-10 09:54

  本文选题：急性缺血性脑卒中　切入点：机械取栓　出处：《介入放射学杂志》2017年03期

【摘要】：目的探讨导丝留置技术在急性脑动脉闭塞机械取栓术中的应用价值、安全性及可行性。方法回顾分析2015年10月至2016年2月采用机械取栓治疗的15例急性缺血性脑卒中患者临床资料,其中大脑中动脉闭塞6例,颈内动脉及大脑中动脉闭塞5例,椎基底动脉闭塞4例。采用导丝留置技术快速准确判断血管闭塞特征,进行血管内机械取栓术治疗。结果 15例患者经导丝留置技术均成功准确判断病变血管闭塞特征。13例(87%)闭塞血管即刻再通,其中10例脑梗死溶栓后血流分级(TICI)评分达3分,5例2b分;2例因血栓负荷量大、闭塞节段长,多次取栓效果不佳,血管再通失败。美国国立卫生研究院卒中量表(NIHSS)评分由术前19.2±7.0改善至术后1周6.3±3.6,差异有统计学意义(P0.01)。术后3个月10例改良Rankin量表(m RS)评分≤2分。结论机械取栓治疗急性脑血管闭塞安全有效,导丝留置技术可安全、方便快捷、准确地判断出闭塞血管特征,减少手术操作,降低手术并发症,提高血管再通率。
[Abstract]:Objective to investigate the value, safety and feasibility of wire guide indwelling technique in mechanical thrombectomy for acute cerebral artery occlusion.Methods the clinical data of 15 patients with acute ischemic stroke treated by mechanical thrombectomy from October 2015 to February 2016 were retrospectively analyzed, including 6 cases of middle cerebral artery occlusion, 5 cases of internal carotid artery occlusion and 5 cases of middle cerebral artery occlusion.Vertebrobasilar artery occlusion in 4 cases.The technique of wire guide indwelling was used to judge the characteristics of vascular occlusion quickly and accurately, and the intravascular mechanical thrombectomy was performed.Results all of the 15 patients were correctly diagnosed by the technique of guiding wire indwelling. 13 patients with occlusive vessel were immediately recanalized. Among them, 10 patients with thrombolytic thrombolytic thrombolytic blood flow grading (TICI) score of 5 patients were 3 points, 2 patients had high thrombus load, 2 patients had high thrombus load, 2 patients had high thrombus load, and 5 patients had high thrombus load after thrombolytic thrombolysis.The segment of occlusion was long, the effect of multiple embolization was not good, and the recanalization of blood vessel failed.The NIHSS score was improved from 19.2 卤7.0 before operation to 6.3 卤3.6 at 1 week postoperatively. The difference was statistically significant (P 0.01).The score of modified Rankin scale was 鈮，

本文编号：1730718