[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):202-205.
 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):202-205.
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导丝留置技术在急性脑动脉闭塞机械取栓中的应用 ()

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

卷:
期数:
2017年03期
页码:
202-205
栏目:
神经介入
出版日期:
2017-03-25

文章信息/Info

Title:
The application of indwelling guide-wire technique in performing mechanical thrombectomy for acute cerebral artery occlusion
作者:
许岗勤 王子亮 汪勇锋 梁晓东 李 立 李天晓
Author(s):
XU Gangqin WANG Ziliang WANG Yongfeng LIANG Xiaodong LI Li LI Tianxiao
Cerebrovascular Interventional Therapy Center, People’s Hospital of Zhengzhou University, Henan Provincial People’s Hospital,Zhengzhou, Henan Province 450003, China
关键词:
【关键词】 急性缺血性脑卒中 机械取栓 导丝留置 Solitaire AB支架
文献标志码:
A
摘要:
【摘要】 目的 探讨导丝留置技术在急性脑动脉闭塞机械取栓术中的应用价值、安全性及可行性。 方法 回顾分析2015年10月至2016年2月采用机械取栓治疗的15例急性缺血性脑卒中患者临床资料,其中大脑中动脉闭塞6例,颈内动脉及大脑中动脉闭塞5例,椎基底动脉闭塞4例。采用导丝留置技术快速准确判断血管闭塞特征,进行血管内机械取栓术治疗。结果 15例患者经导丝留置技术均成功准确判断病变血管闭塞特征。13例(87%)闭塞血管即刻再通,其中10例脑梗死溶栓后血流分级(TICI)评分达3分,5例2b分;2例因血栓负荷量大、闭塞节段长,多次取栓效果不佳,血管再通失败。美国国立卫生研究院卒中量表(NIHSS)评分由术前19.2±7.0改善至术后1周6.3±3.6,差异有统计学意义(P<0.01)。术后3个月10例改良Rankin 量表(mRS)评分≤2分。结论 机械取栓治疗急性脑血管闭塞安全有效,导丝留置技术可安全、方便快捷、准确地判断出闭塞血管特征,减少手术操作,降低手术并发症,提高血管再通率。

参考文献/References:

[1] No authors listed. Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group[J]. N Engl J Med, 1995, 333: 1581?蛳1587.
[2] Sandercock P, Wardlaw JM, Lindley RI, et al. The benefits and harms of intravenous thrombolysis with recombinant tissue plasminogen activator within 6 h of acute ischaemic stroke (the third international stroke trial (IST-3): a randomised controlled trial[J]. Lancet, 2012, 379: 2352-2363.
[3] Hassan AE, Chaudhry SA, Grigoryan MA, et al. National trends in utilization and outcomes of endovascular treatment of acute ischemic stroke patients in the mechanical thrombectomy era[J]. Stroke, 2012, 43: 3012-3017.
[4] Fiehler J, Soderman M, Turjman F, et al. Future trials of endovascular mechanical recanalisation therapy in acute ischemic stroke patients: a position paper endorsed by ESMINT and ESNR part Ⅰ: current situation and major research questions[J]. Neuroradiology, 2012, 54: 1293-1301.
[5] 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.
[6] Goyal M, Demchuk AM, Menon BK, et al. Randomized assessment of rapid endovascular treatment of ischemic stroke[J]. N Engl J Med, 2015, 372: 1019?蛳1030.
[7] Saver JL, Goyal M, Bonafe A, et al. Stent-retriever thrombectomy after intravenous t-PA vs. t-PA alone in stroke[J]. N Engl J Med, 2015, 372: 2285?蛳2295.
[8] Campbell BC, Mitchell PJ, Kleinig TJ, et al. Endovascular therapy for ischemic stroke with perfusion-imaging selection[J]. N Engl J Med, 2015, 372: 1009-1018.
[9] Asadi H, Dowling R, Yan B, et al. Advances in endovascular treatment of acute ischaemic stroke[J]. Intern Med J, 2015, 45: 798-805.
[10] Rha JH, Saver JL. The impact of recanalization on ischemic stroke outcome: a meta-analysis[J]. Stroke, 2007, 38: 967-973.
[11] Koh JS, Lee SJ, Ryu CW, et al. Safety and efficacy of mechanical thrombectomy with Solitaire stent retrieval for acute ischemic stroke: a systematic review[J]. Neurointervention, 2012, 7: 1-9.
[12] 李贵福, 马朝晖, 罗望池, 等. Solitaire AB型支架用于急性脑动脉闭塞取栓术31例[J]. 介入放射学杂志, 2012, 21: 98?蛳102.
[13] 苏治国, 史万超, 胡金明, 等. Solitaire AB支架取栓术治疗急性脑血管闭塞[J]. 中华神经外科杂志, 2014, 30: 613-616.
[14] Kim TK, Rhim JK, Lee CJ, et al. The limitations of thrombectomy with Solitaire AB as first-line treatment in acute ischemic stroke: a single center experience[J]. J Cerebrovasc Endovasc Neurosurg, 2012, 14: 203-209.
[15] 王洪生, 刘 圣, 赵林波, 等. Solitaire AB型支架取栓治疗急性大脑中动脉栓塞疗效分析[J]. 介入放射学杂志, 2015, 24: 658-661.

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备注/Memo

备注/Memo:
(收稿日期:2016-07-11)
(本文编辑:边 佶)
更新日期/Last Update: 2017-03-14