摘要
目的探讨影像导引下机械性血管再通治疗超时间窗急性缺血性脑卒中患者的安全性和有效性。方法收集2013年3月至2014年10月接受机械性血管再通治疗的急性缺血性脑卒中连续患者共91例,其中超时间窗并影像学检查显示有缺血半暗带患者11例（男9例,女2例;中位年龄59岁）。观察11例患者术前、术后30 d美国国立卫生研究院卒中量表（NIHSS）评分变化,根据改良Rankin量表（m RS）评分评估术后90 d患者临床结果。结果 11例患者4条大脑中动脉、3条颈内动脉、4条椎基底动脉接受机械性血管再通治疗（单纯支架成形术10例,机械取栓联合支架成形术1例）,血管再通治疗成功率为90.9%（10/11）,术后30 d内再闭塞率为9.1%（1/11）。术后90 d中位NIHSS评分为4分（0~12分）,与术前中位评分11分（4~35分）相比均明显好转（P〈0.05）;m RS评分0~2分患者由术前0例改善为术后90 d 7例（63.6%,7/11）。结论影像导引下机械性血管再通治疗超时间窗急性缺血性脑卒中患者是安全有效的。
Objective To evaluate the safety and efficacy of imaging-guided mechanical endovascular recanalization therapy in treating patients with over-time-window acute ischemic stroke. Methods A total of 91 consecutive patients with acute ischemic stoke, who were admitted to authors＇ hospital during the period from March 2013 to October 2014 to receive mechanical endovascular recanalization therapy, were collected,among them over-time-window acute ischemic stroke and ischemic penumbra demonstrated on imaging examination were seen in 11 patients, including 9 males and 2 females with a median age of 59 years. Before endovascular recanalization therapy and 30 days after the treatment, NIHSS score changes were determined,and the clinical outcome was evaluated with modified Rankin scale（m RS） at 90 days after the treatment.Results In the 11 patients, mechanical endovascular recanalization was carried out for 4 middle cerebral arteries, 3 internal carotid arteries and 4 vertebral basilar arteries, the therapeutic methods included stent angioplasty（n=10） and mechanical thromboectomy combined with stent angioplasty（n=1）. The recanalization rate was 90.9%（10/11）. Re-occlusion rate within 30 days after management was 9.1%（1/11）. The median NIHSS score determined at 90 days after management was 4 points（0-12 points）, which was significantly（P〈0.05）better than preoperative 11 points（4-35 points）. Before treatment the number of patients with mRS 0-2 points was zero, and the number of patients with mRS 0-2 points increased to 7（63.6%, 7/11） at 90 days after the treatment. Conclusion For the treatment of over-time-window acute ischemic stroke, imaging-guided mechanical end ovascular recanalization therapy is safe and effective.
出处
《介入放射学杂志》
CSCD
北大核心
2016年第4期287-292,共6页
Journal of Interventional Radiology
关键词
影像导引
急性缺血性脑卒中
机械性血管再通
缺血半暗带
imaging guidance
acute ischemic stroke
mechanical endovascular recanalization
ischemic penumbra
