摘要
目的评估大脑中动脉M1段狭窄相关性闭塞与栓塞性闭塞的手术并发症、血管再通率和预后差异。方法回顾性分析216例行血管内治疗的急性大脑中动脉M1段闭塞病例资料。根据病变性质,分为狭窄相关性闭塞组51例和栓塞性闭塞组165例,比较两组病人基线数据和临床预后指标。结果术中取栓装置通过次数在狭窄相关性闭塞组与栓塞性闭塞组分别为1次和2次(P<0.001),中位手术时间分别为63 min和40 min(P=0.036),血管成功再通率(m TICI≥2b级)分别为98.0%和94.5%(P=0.299),m TICI 3级再通率分别为84.3%和53.9%(P<0.001),90 d预后良好率(m RS 0~2分)分别为76.5%和55.2%(P=0.007)。结论与栓塞性闭塞病变比较,狭窄相关性闭塞病变取栓器械通过次数少,m TICI 3级再通率更高。虽然手术操作时间长,但具有良好安全性和有效性。
Objective To evaluate the differences in surgical complications,revascularization rates,and prognosis between stenosisrelated occlusion and embolic occlusion in the M1 segment middle cerebral artery.Methods The clinical data of 216 patients with acute M1 segment middle cerebral artery occlusion undergoing endovascular treatment were analyzed retrospectively.According to classification of vascular occlusion,the patients were divided into stenosis-related occlusion group(51 cases)and embolic occlusion group(165 cases).The baseline data and clinical prognostic indicators were compared between the two groups.Results The number of thrombectomy device passing through the stenosis during the operation was 1 and 2(P<0.001)and the median operation time was63 min and 40 min(P=0.036)respectively in the stenosis-related occlusion group and the embolic occlusion group.Vascular recanalization rates(mTICI≥2 b grade)were 98.0%and 94.5%(P=0.299)and m TICI grade 3 recanalization rates were 84.3%and53.9%(P<0.001)respectively in the stenosis-related occlusion group and the embolic occlusion group.The 90-day good prognosis rate(m RS 0-2 points)was 76.5%and 55.2%(P=0.007)respectively in the stenosis-related occlusion group and the embolic occlusion group.Conclusions Compared with embolic occlusion,the stenosis-related occlusion has fewer passes of thrombectomy equipment and a higher m TICI grade 3 recanalization rate.Although the operation time is longer,it has good safety and effectiveness.
作者
杨文进
李子付
张磊
李翯
张永鑫
张洪剑
沈红健
张永巍
杨鹏飞
刘建民
Yang Wenjin;Li Zifu;Zhang Lei;Li He;Zhang Yongxin;Zhang Hongjian;Shen Hongjian;Zhang Yongwei;Yang Pengfei;Liu Jianmin(Cerebrovascular Disease Center,Changhai Hospital,Naval Medical University(The Second Military Medical University),Shanghai 200433,China)
出处
《中国微侵袭神经外科杂志》
CAS
2020年第4期152-156,共5页
Chinese Journal of Minimally Invasive Neurosurgery
基金
2017年中国脑卒中高危人群干预适宜技术研究及推广项目(编号:GN-2017R0001)。
关键词
脑血管意外
梗塞
大脑中动脉
血栓切除术
血管成形术
cerebrovascular accident
infarction
middle cerebral artery
thrombectomy
angioplasty
