大血管闭塞所致急性进展性卒中血管内治疗的有效性和安全性  

Effectiveness and safety of endovascular therapy for acute progressive stroke caused by large vessel occlusion

作　　者：周元 刘启兵 周溱 周江 许泽武 Zhou Yuan;Liu Qibing;Zhou Zhen;Zhou Jiang;Xu Zewu(Department of Neurology,Yueyang People's Hospital,Yueyang 414000,China;Department of Neurology,Yueyang Central Hospital,Yueyang 414000,China)

机构地区：[1]岳阳市人民医院神经内科,414000 [2]岳阳市中心医院神经内科,414000

出　　处：《国际脑血管病杂志》2023年第3期161-167,共7页International Journal of Cerebrovascular Diseases

摘　　要：目的探讨大血管闭塞(large vessel occlusion,LVO)所致进展性卒中患者血管内治疗的有效性和安全性。方法回顾性纳入2019年1月至2022年2月岳阳市中心医院神经内科收治的LVO所致进展性卒中患者,选择病情进展后阿尔伯塔卒中项目早期CT评分(Alberta Stroke Program Early CT Score,ASPECTS)或后循环ASPECTS(posterior circulation ASPECTS,pc-ASPECTS)≥6分的患者进行血管内治疗,具体方法包括机械血栓切除术、单纯血栓抽吸术、球囊血管成形术、支架置入术或上述方法联合使用。对时间窗内(前循环12 h内、后循环24 h内)和时间窗外(前循环>12 h、后循环>24 h)以及前循环和后循环患者进行比较。结果共纳入20例接受血管内治疗的LVO所致进展性卒中患者。其中,男性17例,女性3例,年龄(59.45±12.06)岁。3例(15%)术后出现颅内出血,无有症状颅内出血患者,12例(60%)术后3个月时转归良好。时间窗内与时间窗外患者以及前循环与后循环患者之间的成功血管再通率、颅内出血发生率和转归不良率差异均无统计学意义。结论对于ASPECTS或pc-ASPECTS评分≥6分的LVO所致进展性卒中患者,进行血管内治疗可能是安全且有效的。Objective To investigate the effectiveness and safety of endovascular therapy for acute progressive stroke caused by large vessel occlusion(LVO).MethodsPatients with progressive stroke caused by LVO admitted to the Department of Neurology,Yueyang Central Hospital from January 2019 to February 2022 were retrospective included.Patients with an Alberta Stroke Program Early CT Score(ASPECTS)or posterior circulation ASPECTS(pc-ASPECTS)≥6 after progression were selected for endovascular therapy,including mechanical thromboectomy,thrombus aspiration,balloon angioplasty,stenting,or a combination of the above methods.Patients in the time window(anterior circulation within 12 h and posterior circulation within 24 h)and outside the time window(anterior circulation>12 h,posterior circulation>24 h)as well as those in the anterior and posterior circulation were compared.ResultsA total of 20 patients with progressive stroke caused by LVO received endovascular treatment were included.There were 17 males and 3 females,aged 59.45±12.06 years.Three patients(15%)developed asymptomatic intracranial hemorrhage,and 12(60%)had a good outcome 3 months after procedure.There were no statistically significant differences in the rate of successful vascular recanalization,incidence of intracranial hemorrhage,and the rate of poor outcomes between patients within and outside the time window and between the patients with anterior and posterior circulation.ConclusionEndovascular therapy may be safe and effective for patients with progressive stroke caused by LVO with ASPECTS or pc-ASPECTS scores≥6.

关 键 词：缺血性卒中 疾病恶化 血管内手术 血栓切除术 颅内出血 治疗结果 

分 类 号：R743.3[医药卫生—神经病学与精神病学]