颅内大动脉慢性闭塞血管内再通的可行性和安全性分析

发布时间：2018-04-22 10:37

  本文选题：颅内大动脉慢性闭塞 + 血管内再通　； 参考：《中国脑血管病杂志》2017年08期

【摘要】：目的探讨血管内介入再通颅内大动脉慢性闭塞的可行性和安全性。方法回顾性分析2009年1月至2017年1月首都医科大学宣武医院神经外科血管内介入再通的15例颅内大动脉慢性闭塞患者的临床和影像学资料。12例为椎动脉V4段闭塞,3例为颈内动脉颅内段闭塞。术前采用全脑DSA评估闭塞长度和位置,用高分辨率MRI评估闭塞性质和再通可行性;术中双侧股动脉置鞘13例,一侧用于再通置入支架,另一侧通过侧支循环代偿充盈闭塞动脉远端作为参考路径图,增加再通可行性。术后根据脑梗死溶栓(TICI)分级系统评估再通后的顺向血流,定义≥2b级为血管成功再通。结果 15例患者首次症状发作到再通时间中位数为50(18~365)d。再通成功13例,2例椎动脉颅内段再通失败。13例再通成功患者中,12例再通后复查造影正向血流恢复至TICI 3级,1例TICI 2b级;7例症状好转,4例症状无变化,1例术后出现短暂性脑缺血发作、1例出现卒中。11例患者随访中位数时间39(3~89)个月后,改良Rankin量表评分中位数为1(0~2)分。结论颅内大动脉慢性闭塞再通,术前采用高分辨率MRI评估以及术中双侧置鞘技术,可能会增加开通率和降低围手术期并发症。
[Abstract]:Objective to investigate the feasibility and safety of interventional recanalization of intracranial artery occlusion. Methods from January 2009 to January 2017, the clinical and imaging data of 15 patients with chronic intracranial artery occlusion in Xuanwu Hospital of Capital Medical University, Xuanwu Hospital, Beijing Medical University, were retrospectively analyzed. Intracranial occlusion of internal carotid artery was found in 3 cases. The length and location of occlusion were evaluated by whole brain DSA before operation, the character of occlusion and the feasibility of recanalization were evaluated by high resolution MRI. To increase the feasibility of recanalization, the other side uses collateral circulation to compensate the distal end of the occluded artery as a reference path map. According to the grading system of thrombolytic thrombolytic thrombolytic therapy (TICI) system after operation, the anterograde blood flow was evaluated, and the grade 鈮，

本文编号：1786872