血管内治疗前循环不同部位及原因血管闭塞导致的急性脑梗死5例分析

发布时间：2018-09-01 20:55

【摘要】：目的探讨前循环不同部位血管病变导致的急性脑梗死患者,经血管内治疗所采取的不同方法以及临床效果和安全性。方法回顾性分析2016年3月-2016年12月采用单纯Solitaire FR支架行急性脑梗死动脉取栓术、中间导管吸栓或结合血管内支架成形,治疗5例具有代表性的前循环不同部位血管闭塞导致的急性脑梗死患者,其中颈内动脉起始部闭塞1例、颈内动脉海绵窦段闭塞1例、颈内动脉起始部重度狭窄合并颈内动脉末端闭塞1例、大脑中动脉M1段闭塞1例、M2段主干闭塞1例。评价取栓或血管内成形治疗后即刻、24 h及术后3 m效果。结果 5例患者均获得闭塞血管再通,但操作方法各异,无明显与操作相关并发症,术后24 h平均NIHSS评分较术前减少7分。术后3 m,5例患者mRS评分0~2分。结论依据不同部位、不同原因的血管闭塞,个体化使用Solitaire FR支架取栓治疗、中间导管血栓抽吸或血管内支架植入术及球囊扩张术等血管成形术,治疗急性脑梗死,能提高闭塞血管的再通率,有效改善颅内外大血管闭塞患者的预后。
[Abstract]:Objective to investigate the different methods, clinical effect and safety of endovascular treatment in patients with acute cerebral infarction caused by different vascular lesions in anterior circulation. Methods from March 2016 to December 2016, Solitaire FR stents were used to treat acute cerebral infarction artery embolization. Five patients with acute cerebral infarction caused by different parts of the anterior circulation were treated, including 1 case of internal carotid artery occlusion and 1 case of carotid cavernous sinus occlusion. There was 1 case with severe stenosis at the beginning of the internal carotid artery and 1 case with occlusion of the end of the internal carotid artery, and 1 case with the occlusion of the main trunk of the M 2 segment of the middle cerebral artery in 1 case. Objective: to evaluate the effect of thrombus removal or intravascular plasty for 24 h and 3 m after operation. Results the recanalization of occluded blood vessels was achieved in all of the 5 patients, but the operation methods were different, and there were no obvious complications associated with operation. The average NIHSS score at 24 hours after operation was 7 points less than that before operation. MRS score was 0 ~ 2 in 5 patients with 3 mm postoperatively. Conclusion according to different sites and different causes of vascular occlusion, Solitaire FR stents are used to treat acute cerebral infarction individually, thrombus aspiration or stent implantation in intermediate catheter and balloon dilatation are used to treat acute cerebral infarction. It can improve the recanalization rate of occluded vessels and improve the prognosis of patients with intracranial and external macrovascular occlusion.
【作者单位】：航天中心医院神经内科;
【分类号】：R743.33

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