[1]韩熙成,韩凯昊,付晓杰,等.急性椎基底动脉闭塞串联病变机械取栓治疗预后分析[J].介入放射学杂志,2021,30(03):225-229.
 HAN Xicheng,HAN Kaihao,FU Xiaojie,et al.Mechanical thrombectomy for acute tandem vertebrobasilar occlusions: analysis of prognosis[J].journal interventional radiology,2021,30(03):225-229.
点击复制

急性椎基底动脉闭塞串联病变机械取栓治疗预后分析()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年03
页码:
225-229
栏目:
神经介入
出版日期:
2021-03-29

文章信息/Info

Title:
Mechanical thrombectomy for acute tandem vertebrobasilar occlusions: analysis of prognosis
作者:
韩熙成 韩凯昊 付晓杰 徐浩文 闫保君 权 涛 赵岩江 管 生
Author(s):
HAN Xicheng HAN Kaihao FU Xiaojie XU Haowen YAN Baojun QUAN Tao ZHAO Yanjiang GUAN Sheng.
Department of Neurology, Suiping Renan Hosipital, Zhumadian, Henan Province 463100, China
关键词:
【关键词】 串联病变 机械取栓 预后 椎基底动脉 闭塞
文献标志码:
A
摘要:
【摘要】 目的 分析急性椎基底动脉闭塞患者机械取栓治疗的预后,评价串联病变对预后的影响。 方法 回顾性分析2015年9月至2019年4月郑州大学第一附属医院等3家医院采用机械取栓治疗的179例椎基底动脉闭塞患者临床和影像学资料。其中串联病变患者20例,单处病变159例。比较分析不同病变组间基线特征、再通率、治疗策略、并发症及90 d预后,评估影响串联病变患者预后的因素。结果 术后总成功再通率为96.6%(173/179),90 d预后良好率为43.6%(78/179)。串联病变组手术时间显著长于单处病变组[(87.0±13.0) min对(67.0±15.0) min,P<0.000 1]。串联病变组、单处病变组预后良好率分别为20.0%、46.5%(P=0.030)。支架植入和替罗非班应用不增加症状性颅内出血和90 d死亡风险。结论 机械取栓能有效改善急性椎基底动脉闭塞患者脑卒中预后,但串联病变手术难度较高,手术时间较长,患者预后较差。

参考文献/References:

[1] Bouslama M, Haussen DC, Aghaebrahim A, et al. Predictors of good outcome after endovascular therapy for vertebrobasilar occlusion stroke[J]. Stroke, 2017, 48: 3252-3257.
[2] Singer OC, Berkefeld J, Nolte CH, et al. Mechanical recanali-zation in basilar artery occlusion: the ENDOSTROKE study[J]. Ann Neurol, 2015, 77: 415-424.
[3] Berkhemer OA, Fransen PS, Beumer D, et al. A randomized trial of intraarterial treatment for acute ischemic stroke[J]. N Engl J Med, 2015, 372: 11-20.
[4] Campbell B, Mitchell PJ, Kleinig TJ, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection[J]. N Engl J Med, 2015, 372: 1009-1018.
[5] Goyal M, Demchuk AM, Menon BK, et al. Randomized assess-ment of rapid endovascular treatment of ischemic stroke[J]. N Engl J Med, 2015, 372: 1019-1030.
[6] Jovin TG, Chamorro A, Cobo E, et al. Thrombectomy within 8 hours after symptom onset in ischemic stroke[J]. N Engl J Med, 2015, 372: 2296-2306.
[7] Albers GW, Marks MP, Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging[J]. N Engl J Med, 2018, 378: 708-718.
[8] Baik SH, Park HJ, Kim JH, et al. Mechanical thrombectomy in subtypes of basilar artery occlusion: relationship to recanalization rate and clinical outcome[J]. Radiology, 2019, 291: 730-737.
[9] Liu X, Dai Q, Ye R, et al. Endovascular treatment versus standard medical treatment for vertebrobasilar artery occlusion(BEST): an open- label, randomised controlled trial[J]. Lancet Neurol, 2020, 19: 115-122.
[10] Quan T, Hou H, Xue W, et al. Endovascular treatment of acute intracranial vertebrobasilar artery occlusion: a multicenter retro-spective observational study[J]. Neuroradiology, 2019, 61: 1477-1484.
[11] 王 斌,檀国军,石秋艳. 12例椎-基底动脉串联病变的血管内治疗探讨[J]. 脑与神经疾病杂志, 2012, 20:294-298.
[12] Cohen JE, Leker RR, Gomori JM, et al. Emergent revasculari-zation of acute tandem vertebrobasilar occlusions: endovascular approaches and technical considerations- confirming the role of vertebral artery ostium stenosis as a cause of vertebrobasilar stroke[J]. J Clin Neurosci, 2016, 34: 70-76.
[13] Piechowiak EI, Kaesmacher J, Zibold F, et al. Endovascular treatment of tandem occlusions in vertebrobasilar stroke: technical aspects and outcome compared with isolated basilar artery occlusion[J]. J Neurointerv Surg, 2020, 12: 25-29.
[14] Baek JH, Kim BM, Kim DJ, et al. Stenting as a rescue treatment after failure of mechanical thrombectomy for anterior circulation large artery occlusion[J]. Stroke, 2016, 47: 2360-2363.
[15] Yoon W, Kim SK, Park MS, et al. Endovascular treatment and the outcomes of atherosclerotic intracranial stenosis in patients with hyperacute stroke[J]. Neurosurgery, 2015, 76: 680-686.
[16] 瞿小锋,李沛城,范伟健,等. 机械取栓治疗心源性和非心源性急性脑卒中有效性和安全性对比分析[J]. 介入放射学杂志,2019, 28:721-725.
[17] Saver JL, Goyal M, Van Der Lugt A, et al. Time to treatment with endovascular thrombectomy and outcomes from ischemic stroke: a meta-analysis[J]. JAMA, 2016, 316: 1279-1288.
[18] Kellert L, Hametner C, Rohde S, et al. Endovascular stroke therapy: tirofiban is associated with risk of fatal intracerebral hemorrhage and poor outcome[J]. Stroke, 2013, 44: 1453-1455.
[19] Zhao W, Che R, Shang S, et al. Low- dose tirofiban improves functional outcome in acute ischemic stroke patients treated with endovascular thrombectomy[J]. Stroke, 2017, 48: 3289-3294.
[20] 周腾飞,朱良付,李天晓,等. 机械取栓和支架植入治疗动脉粥样硬化性颅内大血管闭塞疗效对比研究[J]. 中国卒中杂志,2017, 12:501-505.

相似文献/References:

[1]许岗勤,王子亮,汪勇锋,等.导丝留置技术在急性脑动脉闭塞机械取栓中的应用[J].介入放射学杂志,2017,(03):202.
 XU Gangqin,WANG Ziliang,WANG Yongfeng,et al.The application of indwelling guide-wire technique in performing mechanical thrombectomy for acute cerebral artery occlusion[J].journal interventional radiology,2017,(03):202.
[2]盛柳青,马廉亭,杨 铭,等.重症脑静脉窦血栓形成的超选择窦内置管和机械取栓、碎栓及溶栓治疗[J].介入放射学杂志,2013,(12):969.
 SHENG Liu? qing,MA Lian? ting,YAN Ming,et al.Super-selective catheterization of cerebral venous sinus together with mechanical thrombectomy and thrombolysis for severe cerebral venous sinus thrombosis[J].journal interventional radiology,2013,(03):969.
[3]周腾飞,朱良付,李天晓,等.补救性支架植入治疗急性缺血性脑卒中13例[J].介入放射学杂志,2017,(11):1028.
 ZHOU Tengfei,ZHU Liangfu,LI Tianxiao,et al.Rescue stent implantation for the treatment of acute ischemic stroke: initial experience in 13 patients[J].journal interventional radiology,2017,(03):1028.
[4]倪贵华,倪小宇,刘 旭,等.急性大脑中动脉闭塞的少年脑梗死超时间窗取栓1例 [J].介入放射学杂志,2019,28(02):197.
 NI Guihua,NI Xiaoyu,LIU Xu,et al.Successful mechanical thrombectomy for cerebral infarction beyond time window caused by acute middle cerebral artery occlusion in an early youth patient[J].journal interventional radiology,2019,28(03):197.
[5]陈付文,刘金朝,康孝理,等.Solumbra技术在急性大动脉闭塞性脑梗死机械取栓中的初步应用观察 [J].介入放射学杂志,2019,28(06):515.
 CHEN Fuwen,LIU Jinchao,KANG Xiaoli,et al.Preliminary application of Solumbra technique in mechanical thrombectomy in patients with acute large cerebral artery occlusion stroke[J].journal interventional radiology,2019,28(03):515.
[6]瞿小锋,李沛城,范伟健,等.机械取栓治疗心源性和非心源性急性脑卒中有效性和安全性对比分析[J].介入放射学杂志,2019,28(08):721.
 QU Xiaofeng,LI Peicheng,FAN Weijian,et al.Effectiveness and safety of mechanical thrombectomy for the treatment of stroke: comparative study between acute cardioembolic stroke and acute non- cardioembolic stroke[J].journal interventional radiology,2019,28(03):721.
[7]杨建道,周永明,孟令磊,等.静脉溶栓桥接机械取栓治疗急性脑梗死临床效果[J].介入放射学杂志,2019,28(08):786.
 YANG Jiandao,ZHOU Yongming,MENG Linglei,et al.Clinical effect of intravenous thrombolysis bridged with mechanical thrombectomy for the treatment of acute cerebral infarction[J].journal interventional radiology,2019,28(03):786.
[8]邓小文,李 斌,韩 婷,等.不同卒中分型急性基底动脉闭塞机械取栓临床研究 [J].介入放射学杂志,2020,29(06):541.
 DENG Xiaowen,LI Bin,HAN Ting,et al.Clinical efficacy and safety of mechanical thrombectomy for acute basilar artery occlusion in different types of stroke[J].journal interventional radiology,2020,29(03):541.
[9]邱 凯,施海彬,祖庆泉,等.急性缺血性脑卒中机械取栓后大面积脑梗死发生及其影响因素分析[J].介入放射学杂志,2020,29(12):1182.
 QIU Kai,SHI Haibin,ZU Qingquan,et al.The occurrence of large hemispheric infarction after endovascular thrombectomy for acute ischemic stroke and its influencing factors: a clinical analysis[J].journal interventional radiology,2020,29(03):1182.
[10]高 军,孙 军,张东焕,等.血管内开通治疗急性串联病变型椎基底动脉闭塞临床效果分析[J].介入放射学杂志,2021,30(01):57.
 GAO Jun,SUN Jun,ZHANG Donghuan,et al.Endovascular recanalization for the treatment of acute tandem vertebrobasilar occlusions: analysis of clinical efficacy[J].journal interventional radiology,2021,30(03):57.

备注/Memo

备注/Memo:
(收稿日期:2020-02-28)
(本文编辑:边 佶)
更新日期/Last Update: 2021-03-24