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前循环血管急性闭塞经颈总动脉穿刺取栓

Mechanical thrombectomy for acute anterior circulation large vessel ischemic stroke via common carotid artery
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摘要 目的总结复杂主动脉弓入路条件下经颈动脉直接建立取栓通路的适应证与方法。方法回顾性分析3例经颈动脉直接穿刺建立取栓通路,行急性大血管闭塞血管内取栓治疗的病例资料,同时对相关文献进行分析。结果 3例病人均因主动脉弓结构扭曲不能建立经股动脉穿刺取栓通路,随后经颈动脉直接穿刺建立取栓通路并完成取栓治疗。术后90 d随访预后良好(m RS 1~2分) 2例,死亡1例。结论对主动脉弓重度扭曲而无法行常规经股动脉穿刺行取栓治疗的病例,经慎重评估后行颈动脉直接穿刺取栓治疗可作为备选治疗方法。 Objective To study the indications and methods for the direct percutaneous carotid artery puncture via complex aortic arch approach. Methods The clinical data of 3 patients with acute ischemic stroke undergoing direct carotid artery puncture were analyzed retrospectively. And related literature was reviewed. Results All three patients were unable to establish a femoral artery puncture due to distortion of the aortic arch structure. And a carotid artery puncture was performed to establish a thrombectomy access and complete the thrombectomy. The 90-day good prognosis(mRS 1-2 point) was achieved in 2 patients, and 1 died. Conclusion For patients whose the aortic arch is severely distorted and cannot be treated with conventional femoral artery puncture and thrombectomy, careful carotid puncture and thrombectomy can be used as an alternative treatment after careful evaluation.
作者 王浩 乔宏宇 张磊 李子付 张永鑫 邢鹏飞 沈红健 张永巍 洪波 杨鹏飞 刘建民 Wang Hao;Qiao Hongyu;Zhang Lei;Li Zifu;Zhang Yongxin;Xing Pengfei;Shen Hongjian;Zhang Yongwei;Hong Bo;Yang Pengfei;Liu Jianmin(Departments of Neurosugery,Cerebrovascular Disease Center,Changhai Hospital,Naval Medical University(The Second Military Medical University),Shanghai 200433.China;Neurology Stroke Center,Linyi People's Hospital,Linyi,Shandong 276100,China)
出处 《中国微侵袭神经外科杂志》 CAS 2020年第4期168-170,共3页 Chinese Journal of Minimally Invasive Neurosurgery
关键词 脑血管意外 颈动脉穿刺 血管内治疗 取栓 cerebrovascular accident common carotid artery puncture endovascular treatment thrombectomy
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