大脑后动脉中远段急性闭塞血管内介入治疗初步分析  

Preliminary Analysis of Endovascular Intervention for Acute Occlusion in the Distal Medium Vessel of Posterior Cerebral Artery

作　　者：谌敏 廖德志 李佳 段振晖 万小林 杨运 唐坤[1] 刘文华 郭章宝[1] SHEN Min;LIAO Dezhi;LI Jia;DUAN Zhenhui;WAN Xiaolin;YANG Yun;TANG Kun;LIU Wenhua;GUO Zhangbao(Department of Neurology,Wuhan No.1 Hospital,Wuhan 430022,Hubei,China)

机构地区：[1]武汉市第一医院神经内科,武汉430022

出　　处：《神经损伤与功能重建》2024年第12期740-745,共6页Neural Injury and Functional Reconstruction

基　　金：湖北省武汉市卫生健康委员会科研计划项目(No.WX21C09)。

摘　　要：目的:探讨机械取栓术治疗大脑后动脉中远端血管闭塞的安全性和有效性。方法:纳入武汉市第一医院2017年9月至2023年1月共26例大脑后动脉P2和P3段闭塞接受血管内介入治疗的患者,回顾分析患者的一般情况、血管高危因素、入院美国国立卫生研究院卒中量表(NIHSS)评分、入院时后循环ASPECTS评分、术前静脉溶栓、闭塞部位、发病至穿刺时间、穿刺至再通时间、术后改良梗死溶栓血流分级(mTICI)、出院NIHSS评分、术后90 d随访改良Rankin量表(m RS)、术后90 d内颅内出血发生率和死亡率。结果:26例患者中17例(65.4%)术后即刻血流完全再通(m TICI=3级),23例(88.5%)患者术后即刻成功血流再通(mTICI评分2b级以上),4例(15.4%)患者术后90 d内死亡,术后发生症状性脑出血1例(3.9%),16例(61.5%)患者术后90 d随访mRS评分≤2分。结论:机械取栓术治疗急性大脑后动脉闭塞性卒中其安全性和有效性尚可。Objective:To investigate the safety and effectiveness of mechanical thrombectomy in the treatment of distal medium posterior cerebral artery(PCA)occlusion.Methods:A total of 26 patients with occlusion in the P2 and P3 segments of the PCA who underwent endovascular interventional therapy at Wuhan First Hospital from September 2017 to January 2023 were included.A retrospective analysis was conducted on patients'general characteristics,vascular risk factors,National Institutes of Health Stroke Scale(NIHSS)scores at admission,posterior circulation ASPECTS scores at admission,preoperative intravenous thrombolysis,occlusion sites,time from onset to puncture,time from puncture to revascularization,postoperative modified Thrombolysis In Cerebral Infarction(mTICI)grades,NIHSS scores at discharge,modified Rankin Scale(mRS)scores at 90-day follow-up,and incidence of intracranial hemorrhage and mortality within 90 days postoperatively.Results:Among the 26 patients,17(65.4%)achieved immediate complete revascularization(mTICI grade 3)postoperatively,and 23(88.5%)achieved successful revascularization(mTICI grade≥2b)immediately after surgery.Four patients(15.4%)died within 90 days postoperatively,one patient(3.9%)experienced symptomatic cerebral hemorrhage postoperatively,and 16 patients(61.5%)had m RS scores≤2 at the 90-day follow-up.Conclusion:Mechanical thrombectomy demonstrates acceptable safety and effectiveness in the treatment of acute PCA occlusion stroke.

关 键 词：大脑后动脉闭塞 中远端血管闭塞 血管内治疗 回顾性分析 

分 类 号：R741[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学] R743