中国现代神经疾病杂志 ›› 2020, Vol. 20 ›› Issue (6): 512-518. doi: 10.3969/j.issn.1672-6731.2020.06.008

• 慢性大血管闭塞开通 • 上一篇    下一篇

2 症状性非急性大脑中动脉闭塞血管再通治疗研究

李修珍1, 闫文涛1, 郭姗1, 张振海1, 张晓枫1, 刘爱华2, 刘加春1   

  1. 1. 100093 北京, 首都医科大学三博脑科医院神经介入科;
    2. 100070 首都医科大学附属北京天坛医院神经介入中心 国家神经系统疾病临床医学研究中心
  • 收稿日期:2020-06-14 出版日期:2020-06-25 发布日期:2020-06-24
  • 通讯作者: 刘加春,Email:jiachunliu2003@163.com
  • 基金资助:

    北京市科技计划项目(项目编号:Z171100000417046)

Clinical study on endovascular recanalization of symptomatic non-acute middle cerebral artery occlusion

LI Xiu-zhen1, YAN Wen-tao1, GUO Shan1, ZHANG Zhen-hai1, ZHANG Xiao-feng1, LIU Ai-hua2, LIU Jia-chun1   

  1. 1 Department of Neurological Intervention, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China;
    2 Department of Interventional Neurology, Beijing Tiantan Hospital, Capital Medical University;China;National Clinical Research Center for Neurological Diseases, Beijing 100070, China
  • Received:2020-06-14 Online:2020-06-25 Published:2020-06-24
  • Supported by:

    This study was supported by Beijing Science and Technology Plan Project (No. Z171100000417046).

摘要:

目的 总结症状性非急性大脑中动脉闭塞血管再通治疗的可行性、有效性和安全性。方法 纳入2019年1-12月行血管再通治疗的8例非急性大脑中动脉闭塞患者,记录血管再通成功率、围手术期并发症、预后和支架内再狭窄情况。结果 8例患者中7例血管再通成功,1例失败。其中4例发生围手术期并发症,包括症状性颅内出血(2例)、短暂性脑缺血发作(1例)和支架内血栓形成(1例)。术后7和30 d改良Rankin量表评分0~2分6例、3分1例、4分1例。术后4个月1例发生支架内再狭窄。结论 症状性非急性大脑中动脉闭塞患者,药物治疗效果欠佳时可考虑血管再通治疗,但该项技术复杂,围手术期并发症发生率较高。

关键词: 动脉闭塞性疾病, 大脑中动脉, 血管成形术, 支架, 手术中并发症

Abstract:

Objective To assess the feasibility, safety and short-term outcomes of angioplasty and stenting for patients with symptomatic non-acute middle cerebral artery occlusion (SNAMCAO). Methods Eight SNAMCAO patients who failed in medical treatment and underwent endovascular recanalization, were collected from January to December 2019. The success rate, perioperative complications, prognosis and stent restenosis were summarized. Results In 8 cases, 7 cases succeeded and one case failed. Four cases occurred perioperative complications, including symptomatic intracranial hemorrhage (2 cases), transient ischemic attact (1 case) and stent thrombosis (1 case). Seven to 13 d after operation the modifical Rankin Scale (mRS) 0-2 score were seen in 6 cases, 3 in one case and 4 in one case. Four months after operation one case occurred restenosis in the stent. Conclusions For patients with SNAMCAO, if medical treatment is not effective, endovascular recanalization can be considered, but the recanalization technique is complicated and the incidence of complications is still high. Therefore, the safety and necessity of endovascular recanalization need to be strictly evaluated.

Key words: Arterial occlusive diseases, Middle cerebral artery, Angioplasty, Stents, Intraoperative complications