双支架并联取栓术治疗急性基底动脉闭塞初步研究
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(1.西南医科大学附属医院神经内科,四川省泸州市 646000;2.自贡市第三人民医院神经内科,四川省自贡市 643000)

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袁正洲,博士研究生,主治医师,研究方向为脑血管病及神经介入,E-mail为bibiyou@163.com。通信作者李作孝,硕士,教授,研究方向为脑血管病及神经免疫,E-mail为lzx3235@sina.com。

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Preliminary study of double-stent arallel thrombectomy for acute basilar artery occlusion
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1.Department of Neurology, the Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000;2.Department of Neurology, the Third People's Hospital of Zigong City, Zigong, Sichuan 643000, China)

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    摘要:

    目的 初步探讨双支架取栓治疗急性基底动脉闭塞患者的可行性、有效性及安全性。方法 回顾性分析采用Solitaire FR双支架并联取栓术治疗血栓负荷重的急性基底动脉闭塞所致脑梗死5例患者,统计手术时间,评价取栓后即刻血流再灌注、24 h神经功能改善及术后90天随访mRS评分。结果 5例患者均通过双支架并联取栓术获得闭塞血管良好再通,改良脑梗死溶栓分级(mTICI)为2b-3级,其中完全再通4例(mTICI 3级)。无明显与操作相关并发症,术后24 h NIHSS评分较术前减少10分。术后90天随访,2例患者预后良好,2例残疾,1例患者死亡。结论 使用Solitaire FR双支架并联取栓术治疗血栓负荷重的部分后循环急性脑梗死患者是安全有效的。

    Abstract:

    Aim To explore the feasibility, effectiveness and safety of double-stent thrombectomy in the treatment of acute basilar artery occlusion. Methods Five patients with cerebral infarction caused by acute basilar artery occlusion with heavy thrombus load were retrospectively analyzed. The patients were treated with Solitaire FR double-stent arallel thrombectomy. The operation time, blood flow reperfusion immediately after thrombectomy, 24-hour improvement of nerve function and mRS score of 90-day follow-up after thrombectomy were evaluated. Results Good recanalization of occluded vessels was achieved in five patients by double-stent arallel thrombectomy. The modified thrombolysis in cerebral infarction (mTICI) grading of the patients was 2b-3 grade, of which 4 cases were completely recanalized (mTICI 3 grade). No obvious complication related to operation was found. NIHSS score decreased by 10 points 24 hours after operation compared with that before operation. With follow-up of 90 days after operation, two patients had good prognosis, two were disabled and one died. Conclusion Solitaire FR double-stent arallel thrombectomy is safe and effective in the treatment of acute cerebral infarction patients with partial posterior circulation and heavy thrombosis load.

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袁正洲,李经伦,王力,陈秀,吕志宇,杨元,谢阳,李作孝.双支架并联取栓术治疗急性基底动脉闭塞初步研究[J].中国动脉硬化杂志,2019,27(7):619~623.

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  • 收稿日期:2018-11-18
  • 最后修改日期:2019-01-09
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  • 在线发布日期: 2019-06-04