摘要
目的探究机械取栓(Mechanical thrombectomy,MT)治疗伴机械瓣置换的前循环大血管闭塞(Large vessel occlusion,LVO)急性脑梗死(Acute ischemic stroke,AIS)患者的有效性和安全性。方法回顾性分析2019年1月-2023年6月连续18例行MT治疗伴机械瓣置换的前循环LVO-AIS患者,收集患者的人口学数据、血管危险因素、手术方式、血管再通情况、围手术期并发症及临床预后。结果18例患者中位年龄52.00(41.00,63.25)岁,11例(61.11%)为女性;18例患者的中位穿刺到首次再通时间(Procedural time,PT)为90.00(65.00,138.25)min;18例(100%)患者均达到了有效再通[改良的脑梗死溶栓分级(Modified thrombolysis in cerebral infarction,mTICI)为2b/3级];8例(44.44%)患者功能结局良好[随访术后第90 d改良Rankin量表(Modified Rankin scale,mRS)评分≤0~2分];4例(22.22%)患者术后发生症状性出血(Symptomatic intracranial hemorrhage,sICH)转化。结论在合并机械瓣置换的前循环LVO-AIS患者中行MT有助于恢复血流再灌注,能够给患者带来良好预后。
Objective To explore the efficacy and safety of mechanical thrombectomy(MT)in treating patients with anterior circulation large vessel occlusion acute ischemic stroke(LVO-AIS)with mechanical valve replacement.Methods From January 2019 to June 2023,18 LVO-AIS patients after MT with mechanical valve replacement were retrospectively analyzed.Demographic data,vascular risk factors,surgical methods,vascular recanalization,perioperative complications,clinical prognosis and follow-up data were collected.Results The median age of the 18 patients was 52.00(41.00,63.25)years,and 11(61.11%)were female.The median procedural time(PT)of 18 patients was 90.00(65.00,138.25)minutes.Effective thrombolysis was achieved in18 patients(100%)[modified thrombolysis in cerebral infarction(mTICI)grade 2b/3].After90 days of follow-up,the modified Rankin scale(mRS)≤0~2 points was classified as good prognosis,and 8patients(44.44%)had good functional outcomes.Symptomatic intracranial hemorrhage(sICH)occurred in4patients(22.22%).Conclusion MT in anterior circulation LVO-AIS patients with mechanical valve replacement can help restore reperfusion and can bring good prognosis for patients.
作者
杨蝶
刘振兴
张仁伟
刘煜敏
Yang Die;Liu Zhenring;Zhang Rerwei(Department of Neurology,Zhongnan Hospital of Wuhan Universtiy,Wuhan 430071)
出处
《卒中与神经疾病》
2024年第4期331-336,共6页
Stroke and Nervous Diseases
关键词
机械瓣置换术
机械取栓
急性缺血性脑卒中
抗凝治疗
Mechanical heart valves
Mechanical thrombectomy
Acute ischemic stroke
Anticoagu-lation
