介入再通治疗非急性期基底动脉闭塞的中长期随访研究  

Medium and long term follow-up of revascularization and stenting of nonacute basilar artery occlusion

作　　者：贺迎坤[1] 李天晓[1] 王子亮[1] 常凯涛 朱良付[1] 薛绛宇[1] 白卫星[1] 李钊硕[1] 许斌[1] 

机构地区：[1]郑州大学人民医院介入科脑血管病区,河南省人民医院国家高级卒中中心,河南省介入治疗中心,450001

出　　处：《中华介入放射学电子杂志》2016年第2期59-62,共4页Chinese Journal of Interventional Radiology：electronic edition

基　　金：河南省重点科技攻关项目(152102310416;162102310268);河南省卫生科技攻关项目(201403191)

摘　　要：目的 评价介入再通治疗非急性期基底动脉闭塞的中长期临床疗效。方法 收集2010年2月—2012年4月在我中心行介入再通治疗的闭塞超过24 h的非急性期基底动脉闭塞患者12例。记录围手术期并发症、随访期间短暂性脑缺血发作及卒中发生情况，使用非参数秩和检验比较手术前后及随访期间的改良Rankin量表（mRS）评分变化情况。结果 12例患者中有11例闭塞动脉（91.7％）成功开通。围手术期并发症发生2例,导致患者病情加重。8例患者获得影像学随访，中位随访时间12（6～30）个月，再狭窄2例，均为症状性。12例患者获得临床随访，中位随访时间51.5（0.5～73）个月，再发同侧性卒中2例，同侧性短暂性脑缺血发作1例。存活患者中，术后7 d的mRS评分低于术前，术后3个月mRS评分低于术后7 d，差异有统计学意义（P〈0.05）。结论 介入再通治疗非急性期基底动脉闭塞可在中远期预防再发缺血事件的发生，同时术后3月内患者的残疾功能改善明显，但再狭窄问题值得进一步关注。Objective To evaluate the medium and long term follow-up outcome of revascularization and stenting of nonacute basilar artery occlusion.Methods Consecutive data of 12 patients who suffered nonacute basilar artery occlusion beyond 24 hours and underwent endovascular revascularization, were retrospectively collected and analyzed. Complications and recurrent ischemic events during the follow-up period were recorded. The modified Rankin scale （mRS） scores were used and compared between pre- and postoperative. Results All 12 patients but 1 （91.7.%） obtained successful recanalization. Two patients suffered procedural complications and both of them resulted in aggravation. 8 patient received imaging follow-up during the median 12 months, 2 restenosis occurred and both of them are symptomatic.And during median 51.5 months clinical follow-up after operation,2 ipsilateral stroke and 1 ipsilateral transient ischemic attack occurred. The mRS scores decreased significantly in the first 3 months after procedure in survivors.Conclusions Revascularization and stenting of nonacute basilar artery occlusion can prevent recurrent ipsilateral ischemic event and improves disability recovery, but there-stenosis should give more attention.

关 键 词：基底动脉闭塞 非急性期 介入治疗 改良Rankin量表 

分 类 号：R743[医药卫生—神经病学与精神病学]