非急性期闭塞性长段颈内动脉夹层血管内治疗初步探讨  

Preliminary discussion on the endovascular recanalization for non-acute long-segment internal carotid artery occlusive dissection

作　　者：刘朝[1] 王子尧 李冬冬[1] 刘兵辉 李进一[1] 陈振[1] 徐浩文[1] 管生[1] LIU Chao;WANG Ziyao;LI Dongdong;LIU Binghui;LI Jinyi;CHEN Zhen;XU Haowen;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(河南省神经介入工程研究中心),河南郑州450052

出　　处：《介入放射学杂志》2023年第8期736-740,共5页Journal of Interventional Radiology

基　　金：河南省高等学校重点科研项目计划(23A320013)。

摘　　要：目的探讨血管内开通非急性期闭塞性颈内动脉夹层的可行性和安全性。方法回顾性分析2019年1月至2021年12月郑州大学第一附属医院采用非急性期血管内开通治疗的闭塞性颈内动脉夹层患者基础资料,记录生化数据、影像学特征及中远期随访结果。结果共纳入11例非急性症状性颈动脉夹层患者,男8例,女3例,年龄(50.5±9.7)岁,发病时间39.82(21,60)d。自发性夹层10例,创伤性夹层1例。接受单纯血管成形治疗8例,血管成形联合血栓清除2例,单纯血栓清除1例。所有患者均成功开通血管,无围手术期并发症发生。中远期随访6个月时2例出现轻度再狭窄,但1例13个月时夹层消失。结论血管内治疗非急性闭塞性颈动脉夹层具有一定的可行性和安全性,但需要更大样本研究进一步验证。Objective To discuss the clinical feasibility and safety of endovascular recanalization in treating non-acute long-segment internal carotid artery occlusive dissection.Methods The clinical data of 11 consecutive patients with non-acute long-segment internal carotid artery occlusive dissection,who were admitted to the First Affiliated Hospital of Zhengzhou University of China to receive endovascular recanalization therapy between January 2019 and December 2021,were retrospective analyzed.The biochemical data,imaging characteristics,and mid-to-long-term follow-up results were recorded.Results The 11l patients with non-acute symptomatic internal carotid artery occlusive dissection included 8 males and 3 females,with a mean age of(50.5±9.7)years,the average time of onset was 39.82(21,60)days.Spontaneous internal carotid artery occlusive dissection was seen in 10 patients and traumatic internal carotid artery occlusive dissection was seen in one patient.Angioplasty treatment alone was employed in 8 patients,angioplasty combined with thrombectomy was adopted in 2 patients,and thrombectomy alone was used in one patient.Successful recanalization was achieved in all the 1l patients,and no perioperative complications occurred.During a 6-month follow-up period,2 patients developed a mild restenosis,and the dissection disappeared in one patient 13 months after treatment.Conclusion For the treatment of non-acute long-segment internal carotid artery occlusive dissection,endovascular recanalization therapy carries certain clinical feasibility and safety,but more studies with larger samples need to be conducted before its clinical effect can be further clarified.

关 键 词：颈动脉夹层 血管内治疗 缺血性脑卒中 自发性夹层 

分 类 号：R743.33[医药卫生—神经病学与精神病学]