Solitaire支架血管内治疗院内急性缺血性卒中  

Intra-arterial treatment with solitaire stent retrieval for acute ischemic stroke in hospital

作　　者：曹洁[1] 彭亚[1] 宣井岗[1] 陈荣华[1] 朱旭成[1] 邵华明[1] 

机构地区：[1]常州市第一人民医院神经外科(苏州大学附属第三医院),213003

出　　处：《临床神经外科杂志》2015年第6期442-444,448,共4页Journal of Clinical Neurosurgery

基　　金：国家十二五科技支撑计划项目(2011BAI08B00);2014江苏省省级条件建设与民生科技专项资金(BL2014035)

摘　　要：目的探讨院内急性缺血性卒中的临床特点及Solitaire支架血管内治疗的疗效。方法回顾性分析12例常州市第一人民医院2012年5月至2014年12月院内急性缺血性卒中患者的临床资料,12例均为大脑中动脉闭塞,其中合并同侧颈内动脉闭塞1例,合并同侧颈内动脉夹层1例,合并大脑后动脉闭塞1例,合并基底动脉闭塞1例。美国国立卫生研究院卒中量表（NIHSS）评估患者发病及术后的神经功能,改良RANKIN量表（mRS）评估患者的预后,并记录患者发病至血管再通的时间。结果 12例均选择Solitaire支架血管内治疗,10例行Solitaire支架机械取栓术,2例行Solitaire支架植入术。术前NIHSS评分（18.1±6.3）分（10~31分）,发病至血管再通时间（234.2±155.9）min（60~654 min）,术中血管再通TICI 2b级4例,3级8例,术后死亡5例,3例为心源性死亡,1例为大面积脑梗死,1例高龄（83岁）心肺功能障碍。7例患者获得随访,出院NIHSS评分（2.7±2.6）分（0~8分）,术后3月随访mRS≤2分6例（50%）,mRS〉2分1例（8.3%）。结论院内急性缺血性卒中更具复杂性和隐蔽性,Solitaire支架血管内治疗是治疗院内急性缺血卒中的有效方法。Objective To explore the clinical characteristics of acute ischemic stroke in hospital and therapeutic effect of intra-arterial treatment with solitaire stent retrieval. Method The clinical data of 12 patients with acute isehemie stroke treated in hospital were analyzed retrospectively. The vessel occlusions of 12 cases occurred in the middle cerebral artery. Among them, 1 case was associated with ipsilateral internal carotid artery occlusion, 1 case was associated ipsilateral internal carotid artery dissection, 1 case was associated with posterior cerebral artery occlusion and 1 case with basic artery occlusion. The neurological outcomes were assessed using the National Institutes of Health Stroke Scale and the modified Rankin Scale. Time was recorded from the symptom onset to the recanalization and procedure time. Results All patients were underwent intra-arterial treatment with solitaire stent retrieval. The National Institutes of Health Stroke Seale seores was （18.1 ±6.3）（ range from 7 to 31 ） at presentation. The mean time from symptom onset to recanalization was （ 234.2 ±155.9 ）minutes（ range 60 -654 minutes）. The overall reeanalization rate （thrombolysis in cerebral inf- arction seores of 3 or 2b） was 100%. The National Institutes of Health Stroke Seale scores was（2.7 ±2.6） （range from 0 to 8） at diseharge. 50% of the patients had a modified Rankin Scale score ~〈2, with an overall mortality rate of 41.7%. Conclusions Acute isehemie stroke in hospital is more complex and undeteetable. Intra-arterial treatment with Solitaire stent retrieval is feasible in the treatment.

关 键 词：机械取栓 急性缺血性卒中 院内卒中 大脑中动脉 Solitaire支架 

分 类 号：R651.1[医药卫生—外科学]