双支架取栓技术在急性颅内大动脉T形分叉处闭塞的应用  

Application of double stent-retriever thrombectomy in acute intracranial macrovascular occlusion at T-shaped bifurcation

作　　者：丁明祥[1] 黄晓光 谢兵[1] 李兵 胡恺 韩志安[1] DING Ming-xiang(Department of Cerebrovascular Intervention,Zhongshan People's Hospital,Zhongshan,Guangdong,528400,China)

机构地区：[1]中山市人民医院脑血管介入科,广东中山528400

出　　处：《齐齐哈尔医学院学报》2020年第17期2117-2119,共3页Journal of Qiqihar Medical University

基　　金：中山市医学科研项目(2020A020529)。

摘　　要：目的观察研究双支架取栓技术治疗颅内大动脉T形分叉处闭塞的有效性和安全性。方法回顾性分析2018年3月—2019年8月本院脑血管介入科使用双支架取栓的急性颅内大动脉T形分叉处闭塞6例患者的临床资料,分析该技术的效果和术后并发症情况。结果5例患者实现成功血管再通,改良脑梗死溶栓分级(mTICI分级)2b^3级,5例均为双支架取栓一次再通。1例患者双支架取栓2次,再通失败,术后出现大面积脑梗塞。5例患者股动脉穿刺到再通中位时间为69分钟,术后复查CT均无操作性出血。6例患者完成90天随访,90天mRS评分4例≤2分,2例死亡。结论使用双支架取栓技术治疗颅内大动脉T形分叉处闭塞再通率较高,这种治疗方案安全有效,可在临床推广使用。Objective To observe the effectiveness and safety of double stent-retriever thrombectomy in the treatment of acute intracranial macrovascular occlusion at T-shaped bifurcation.Methods Retrospectively analyzed the collected clinical data of 6 patients with acute intracranial macrovascular occlusion at T-shaped bifurcation those treated by double stent-retriever thrombectomy in the department of cerebrovascular intervention of Zhongshan people's hospital from March 2018 to August 2019.The effects of this technology and the occurrence of postoperative complications were analyzed.Results After thrombectomy,5 patients achieved successful vascular recanalization,the modified thrombolysis in cerebral infarction(mTICI)achieved grade 2b-3,all of which were performed once with double stent-retriever.1 case was performed twice with double stent-retriever,finally the recanalization failed,a large-scale cerebral infarction occurred after the operation.The median time from puncture to recanalization of the 5 patients was 69 minutes,and no postoperative cerebral hemorrhage was found on CT review.All the 6 patients completed a 90-day follow-up,of which 4 patients had an mRS score equal or less than 2 points at 90 days and 2 died.Conclusions The double stent-retriever thrombectomy which used to treat the acute intracranial macrovascular occlusion at T-shaped bifurcation achieves high recanalization rate,and the technique is safe and effective,it could be promoted in clinic.

关 键 词：卒中 颅内大动脉闭塞 双支架 取栓 

分 类 号：R743.3[医药卫生—神经病学与精神病学]