球囊接力技术在急性颈内动脉串联闭塞治疗中的临床应用  

Clinical application of relay-balloon technique in the treatment of acute internal carotid artery tandem occlusion

作　　者：余丹枫 徐渭 何平游 陈峰 刘晓波[1] 蒋烽烽[1] 鲍翔[1] Yu Danfeng;Xu Wei;He Pingyou;Chen Feng;Liu Xiaobo;Jiang Fengfeng;Bao Xiang(Department of Neurosurgery,Jinhua Central Hospital,Jinhua 321000,China)

机构地区：[1]浙江省金华市中心医院神经外科,321000

出　　处：《心脑血管病防治》2024年第8期20-23,36,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨球囊接力技术在急性颈内动脉串联闭塞血管内治疗中的有效性和安全性。方法回顾性分析金华市中心医院2019年1月至2022年6月急性颈内动脉串联闭塞患者39例,根据手术方式分为球囊接力组(29例)和PEARS组(10例)。收集两组近端通路建立时间、血管再通时间、手术时间、取栓次数、血管再通程度、术中血栓逃逸、围手术期脑出血、术后大面积脑梗死、术后48 h美国国立卫生研究院卒中量表(NIHSS)评分、术后90 d改良Rankin量表(mRS)评分等临床指标,进行统计分析。结果球囊接力组近端通路建立时间、血管再通时间、手术时间、取栓次数、血管有效再通率、术中血栓逃逸率、术后NIHSS评分改善、大面积脑梗死、症状性颅内出血和术后mRS评分等方面均优于PEARS组,但两组间差异无统计学意义(均P>0.05)。结论在急性颈内动脉串联闭塞血管内治疗应用中,球囊接力技术具有安全性与有效性,在近端通路建立时间、血管再通时间、手术时间上可能有一定优势,在术中血栓逃逸、术后并发症以及术后神经功能恢复上可能存在潜在的优势,还需大样本研究进行验证。Objective To explore the efficacy and safety of realy-balloon technique in the treatment of acute internal carotid artery tandem occlusion.Methods A retrospective analysis was conducted on 39 patients with acute internal carotid artery tandem occlusion treated at Jinhua Central Hospital from January 2019 to June 2022.The patients were divided into the realy-balloon technique group(29 cases)and the protect expand aspiration revascularization stent(PEARS)group(10 cases)based on the surgical approach.Clinical indicators,including proximal access establishment time,vascular recanalization time,surgery time,number of embolectomy,vascular recanalization degree,intraoperative thrombus escape,perioperative cerebral hemorrhage,postoperative massive cerebral infarction,postoperative 48-hour National Institute of Health Stroke Scale(NIHSS)score,and 90-day modified Rankin Scale(mRS)score,were collected and statistically analyzed.Results Compared to the PEARS group,the realy-balloon technique group showed advantages in the proximal access establishment time,recanalization time,surgery time,number of embolectomy,effective vascular recanalization rate,intraoperative thrombus escape rate,improvement in postoperative NIHSS score,massive cerebral infarction,symptomatic intracranial hemorrhage,and postoperative mRS score.However,the differences between the two groups were not statistically significant(all P>0.05).Conclusion The treatment of acute internal carotid artery tandem occlusion by the realy-balloon technique is safe and effective.There may be some advantages in the proximal access establishment time,vascular recanalization time and surgery time.It may also demonstrate potential advantages in intraoperative thrombus escape,postoperative complication,and postoperative neurological function recovery.Further studies with larger sample sizes are needed for validation.

关 键 词：球囊接力技术 逆向开通 PEARS技术 颈内动脉串联闭塞 

分 类 号：R743.3[医药卫生—神经病学与精神病学]