支架取栓联合局部溶栓治疗重型颅内静脉窦血栓形成临床研究  

Stent-retrievers combined with local thrombolysis for the treatment of severe cerebral venous sinus thrombosis:a clinical study

作　　者：孙刘严 郭新宾[1] 魏森[1] 杨震[1] 王晶晶 管生[1] SUN Liuyan;GUO Xinbin;WEI Sen;YANG Zhen;WANG Jingjing;GUAN Sheng(Department of Neurological Intervention,First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan Province 450052,China)

机构地区：[1]郑州大学第一附属医院神经介入科,450052

出　　处：《介入放射学杂志》2021年第7期643-646,共4页Journal of Interventional Radiology

摘　　要：目的探讨支架取栓联合局部静脉窦溶栓治疗重型颅内静脉窦血栓形成(CVST)患者的安全性和有效性。方法回顾性分析郑州大学第一附属医院2015年10月至2019年8月经磁共振静脉造影(MRV)或DSA确诊的26例重型CVST患者临床资料。所有患者均接受支架取栓联合术中或术后局部静脉窦溶栓治疗。MRV或DSA评估联合治疗后静脉窦再通情况。改良Rankin量表(mRS)评分评估患者入院、出院和随访结果。结果26例患者中男女各13例,年龄13~66岁,平均(30.0±13.0)岁。所有患者支架取栓联合局部静脉窦溶栓治疗均获成功。7例(26.9%)完全再通,19例(73.1%)部分再通。术后出现脑梗死1例,新发脑出血8例(包括2例大的出血性脑梗死)。随访1~6个月,患者入院与出院mRS评分差异有统计学意义(P<0.01),预后良好率为96.2%(25/26),无复发。结论支架取栓联合局部静脉窦溶栓治疗重型CVST安全可行,对抗凝治疗无效的重症患者是一种可能的补救方法。Objective To investigate the safety and effective of stent-retrievers combined with local venous thrombolysis in treating patients with severe cerebral venous sinus thrombosis(CVST).Methods The clinical data of 26 patients with magnetic resonance venography(MRV)confirmed or digital subtraction angiography(DSA)confirmed severe CVST,who were admitted to the First Affiliated Hospital of Zhengzhou University of China between October 2015 and August 2019,were retrospectively analyzed.All patients received stent-retrievers combined with intraoperative or postoperative local venous thrombolysis treatment.After combination treatment the recanalization of venous sinuses was assessed by MRV or DSA.Modified Rankin Scale(mRS)score was used to evaluate patient’s condition at the time of admission,discharge and during follow-up period.Results The patients included 13 males and 13 females,aged 13-66 years with a mean of(30.0±13.0)years.Successful stent-retrievers combined with intraoperative or postoperative local venous thrombolysis treatment was accomplished in all patients.Complete recanalization was achieved in 7 patients(26.9%)and partial recanalization in 19 patients(73.1%).After treatment,cerebral infarction occurred in one patient and newly-developed cerebral hemorrhage in 8 patients(including massive hemorrhagic cerebral infarction in 2 patients).The patients were followed up for 1-6 months.The difference between admission m RS score and discharge mRS score was statistically significant(P<0.01).The good prognosis rate was 96.2%(25/26).No recurrence was observed.Conclusion For the treatment of severe CVST,stent-retrievers combined with local venous sinus thrombolysis is clinically safe and technically feasible,it is a remedial therapeutic method for severe CVST patients who have failed to respond anticoagulation therapy.(J Intervent Radiol,2021,30:643-646)

关 键 词：颅内静脉窦血栓形成 支架 机械取栓 溶栓 

分 类 号：R743[医药卫生—神经病学与精神病学]