摘要
目的研究远端取栓支架保护下逆向开通的手术策略对前循环串联病变的疗效和安全性。方法选取2018年1月至2023年12月成都西区医院接受介入开通手术的42例前循环串联病变急性缺血性卒中患者作为研究对象。根据手术策略分为观察组(n=23,采用远端支架保护)和对照组(n=19,采用保护伞保护)。比较两组间术中血栓逃逸率、术后24 h症状性颅内出血(SICH)发生率、成功开通率、总手术时间、术后90 d良好预后率及死亡率。结果两组患者均全部成功开通,开通率100%。两组患者90 d良好预后率及致死率、术后24 h SICH发生率、总手术时间等比较差异无统计学意义(P>0.05)。观察组血栓远端逃逸率(4.3%)低于观察组(26.3%),差异有统计学意义(P=0.043)。结论在前循环串联病变开通术中,采用远端支架保护下逆向开通手术策略具有更低的血栓逃逸率,疗效和安全性方面与传统颈动脉保护伞下逆向开通相当。
Objective To investigate the safety and efficacy of the surgical strategy of reversely opening under the protection of distal thrombectomy stent on anterior circulation tandem lesions.Methods A total of 42 patients with acute ischemic stroke with anterior circulation tandem lesions receiving opening surgery from January 2018 to December 2023 were selected as the study subjects.According to the surgical strategy,the patients were divided into the observation group(n=23,adopting the distant stent protection)and the control group(n=19,adopting the protective umbrella protection).The intraoperative thrombus escape rate,incidence rate of 24 h symptomatic intracranial hemorrhage(SICH),successful opening rate,total operation time,good prognosis rate and mortality rate on postoperative 90 d were compared between the two groups.Results All patients in the both groups were successfully opened,and the opening rate was 100%.There were no statistically significant differences in the 90 d good prognosis rate and mortality rate,SICH incidence rate at postoperative 24 h and total operation duration between the both groups(P>0.05).The thrombus distal end escape rate in the observation group was lower than that in the control group with statistically significant difference(4.3%vs.26.3%,P=0.043).Conclusion In the opening operation of anterior circulation tandem lesions,adopting the reverse opening surgical strategy under the distal stents protection has a lower thrombus escape rate,which is comparable to that of reverse opening under the traditional carotid artery protective umbrella in the aspects of effect and safety.
作者
童贵
王志强
范进
李曦
TONG Gui;WANG Zhiqiang;FAN Jin;LI Xi(Department of Neurology,Chengdu West District Hospital,Chengdu,Sichuan 610036,China;Department of Neurology,Chengdu BOE Hospital,Chengdu,Sichuan 611743,China;Department of Neurology,Western Theater General Hospital of PLA,Chengdu,Sichuan 610038,China)
出处
《重庆医学》
CAS
2024年第16期2467-2471,共5页
Chongqing Medical Journal
基金
四川省医学青年创新科研课题(Q22099)。
关键词
前循环串联病变
逆向开通
安全性
疗效
远端支架保护
anterior circulation tandem lesions
reverse opening
safety
efficacy
distal stent protection
