本文選題：顱內(nèi)大動(dòng)脈慢性閉塞 + 血管內(nèi)再通　； 參考：《中國(guó)腦血管病雜志》2017年08期

【摘要】：目的探討血管內(nèi)介入再通顱內(nèi)大動(dòng)脈慢性閉塞的可行性和安全性。方法回顧性分析2009年1月至2017年1月首都醫(yī)科大學(xué)宣武醫(yī)院神經(jīng)外科血管內(nèi)介入再通的15例顱內(nèi)大動(dòng)脈慢性閉塞患者的臨床和影像學(xué)資料。12例為椎動(dòng)脈V4段閉塞,3例為頸內(nèi)動(dòng)脈顱內(nèi)段閉塞。術(shù)前采用全腦DSA評(píng)估閉塞長(zhǎng)度和位置,用高分辨率MRI評(píng)估閉塞性質(zhì)和再通可行性;術(shù)中雙側(cè)股動(dòng)脈置鞘13例,一側(cè)用于再通置入支架,另一側(cè)通過(guò)側(cè)支循環(huán)代償充盈閉塞動(dòng)脈遠(yuǎn)端作為參考路徑圖,增加再通可行性。術(shù)后根據(jù)腦梗死溶栓(TICI)分級(jí)系統(tǒng)評(píng)估再通后的順向血流,定義≥2b級(jí)為血管成功再通。結(jié)果 15例患者首次癥狀發(fā)作到再通時(shí)間中位數(shù)為50(18~365)d。再通成功13例,2例椎動(dòng)脈顱內(nèi)段再通失敗。13例再通成功患者中,12例再通后復(fù)查造影正向血流恢復(fù)至TICI 3級(jí),1例TICI 2b級(jí);7例癥狀好轉(zhuǎn),4例癥狀無(wú)變化,1例術(shù)后出現(xiàn)短暫性腦缺血發(fā)作、1例出現(xiàn)卒中。11例患者隨訪中位數(shù)時(shí)間39(3~89)個(gè)月后,改良Rankin量表評(píng)分中位數(shù)為1(0~2)分。結(jié)論顱內(nèi)大動(dòng)脈慢性閉塞再通,術(shù)前采用高分辨率MRI評(píng)估以及術(shù)中雙側(cè)置鞘技術(shù),可能會(huì)增加開通率和降低圍手術(shù)期并發(fā)癥。
[Abstract]:Objective to investigate the feasibility and safety of interventional recanalization of intracranial artery occlusion. Methods from January 2009 to January 2017, the clinical and imaging data of 15 patients with chronic intracranial artery occlusion in Xuanwu Hospital of Capital Medical University, Xuanwu Hospital, Beijing Medical University, were retrospectively analyzed. Intracranial occlusion of internal carotid artery was found in 3 cases. The length and location of occlusion were evaluated by whole brain DSA before operation, the character of occlusion and the feasibility of recanalization were evaluated by high resolution MRI. To increase the feasibility of recanalization, the other side uses collateral circulation to compensate the distal end of the occluded artery as a reference path map. According to the grading system of thrombolytic thrombolytic thrombolytic therapy (TICI) system after operation, the anterograde blood flow was evaluated, and the grade 鈮，

本文編號(hào)：1786872