基底动脉原位狭窄伴急性闭塞血管内治疗的有效性和安全性分析  

Safeness and effectiveness of endovascular therapy for basilar artery acute occlusion with stenosis

作　　者：谈晓星 曹洁[1] 朱旭成[1] 陈荣华[1] 邵华明[1] 宣井岗[1] 彭亚[1] TAN Xiao-xing;CAO Jie;ZHU Xu-cheng(Department of Neurosurgery,Third Affiliated Hospital of Soochow University,Changzhou 213003,China)

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

出　　处：《临床神经外科杂志》2021年第4期371-374,380,共5页Journal of Clinical Neurosurgery

基　　金：常州市科技项目(CE20205025)。

摘　　要：目的探讨基底动脉原位狭窄并急性闭塞行血管内治疗的有效性和安全性。方法回顾性分析28例基底动脉原位狭窄伴急性闭塞行血管内治疗患者的临床资料。28例患者在发病6~8 h内接受一种或多种血管内治疗技术再通血管。入院时采用美国国立卫生研究院卒中量表(NIHSS)和格拉斯哥昏迷量表(GCS)评估患者的神经功能,术后即刻采用m TICI分级评估血管再通程度,术后72 h复查头颅MRI或CT,随访采用mRS评分评估患者术后90 d的预后。结果术中即刻血管造影评估血管再通率:25例患者(89.3%)血管再通良好,3例患者(10.7%)血管再通不良。术后90 d随访,预后良好患者16例(57.1%),预后不良患者12例(42.9%)。其中死亡7例(25%),术后症状性颅内出血1例(3.6%);无血管内治疗手术相关并发症发生。结论血管内治疗基底动脉原位狭窄伴急性闭塞是有效、安全的。Objective To investigate the effectiveness and safety of endovascular treatment of basilar artery acute occlusion with stenosis.MethodsThe clinical data of 28 patients with basilar artery stenosis in situ and acute occlusion were retrospectively analyzed.They were treated with one or more endovascular treatment techniques within 6-8 h after onset.The National Institute of Health Stroke Scale(NIHSS)and Glasgow coma scale(GCS)were used to assess the patient’s neurological function during admission.The degree of vascular recanalization was evaluated by modified Thrombolysis In Cerebral Infarction(mTICI).Patient’s intracranial situation were assessed by MRI or CT 72 hours after surgery.The prognosis of patients were assessed at 90-day with Modified Rankin Scale.Results25 patients(89.3%)had good vascular recanalization and 3(10.7%)had poor vascular recanalization by intraoperative angiography.On 90 days follow-up,16 patients(57.1%)had better curative effect,12(42.9%)had poor curative effect and the mortality was 25%.There were no complications of endovascular therapy.Conclusion Endovascular treatment of basilar artery acute occlusion with stenosis is effective and safe.

关 键 词：急性缺血性卒中 基底动脉 大动脉粥样硬化型 血管内治疗 

分 类 号：R651[医药卫生—外科学]