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颈动脉残端综合征病例系列研究及文献回顾

Carotid stump syndrome:A case series study and literature review
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摘要 目的 评价血管内介入治疗对于颈动脉残端综合征(CSS)所引起的急性缺血性卒中的临床效果。方法 本研究回顾性收集了2018年8月—2022年10月间就诊于吉林大学第一医院接受血管内介入治疗的前循环急性缺血性卒中患者,并筛选由CSS引起的急性缺血性卒中患者,收集患者人口学信息、危险因素、手术相关特征及预后,分析血管内治疗的效果。结果 共23例患者满足CSS的诊断标准,其中19例患者实现再通,7例患者实现了延伸的脑梗死溶栓分级(eTICI)3级。14例同期植入了颈动脉支架。12例患者术后出现了颅内出血,其中1例出现症状性颅内出血(sICH),并因此于院内死亡。发病90 d时,共有8例患者实现了功能独立(mRS≤2),4例患者在90 d内死亡。结论 CSS是一种临床综合征,由闭塞的颈内动脉远端栓子脱落引起的颅内动脉栓塞。血管内介入治疗是治疗CSS的有效方法。 Objective To investigate the clinical efficacy of endovascular intervention in the treatment of acute ischemic stroke caused by carotid stump syndrome(CSS).Methods A retrospective analysis was performed for the patients with anterior circulation acute ischemic stroke who underwent endovascular intervention in The First Hospital of Jilin University from August 2018 to October 2022,among whom the patients with acute ischemic stroke caused by CSS were identified,and related data were collected for these patients,including demographic information,risk factors,surgery-related characteristics,and prognosis.Results A total of 23 patients met the diagnostic criteria for CSS,among whom 19 patients achieved successful revascularization and 7 achieved extended Thrombolysis in Cerebral Infarction(eTICI)grade 3.Fourteen patients received concurrent carotid artery stenting.Twelve patients experienced intracranial hemorrhage after surgery,among whom 1 patient experienced symptomatic intracranial hemorrhage(sICH)leading to inhospital death.On day 90 after onset,8 patients achieved functional independence,with a modified Rankin Scale score of≤2,while 4 patients died within 90 days.Conclusion CSS is a clinical syndrome caused by embolization from the occluded distal portion of the internal carotid artery.Endovascular intervention is an effective method for the treatment of CSS.
作者 宋康佳 李超 徐保锋 周杰 岳飞学 张文彬 王守春 SONG Kangjia;LI Chao;XU Baofeng(Neu-rology Department,The First Hospital of Jilin University,Changchun 130000,China)
出处 《中风与神经疾病杂志》 CAS 2024年第9期782-787,F0002,共7页 Journal of Apoplexy and Nervous Diseases
基金 吉林省财政厅资助项目(JLSCZD2019-013) 吉林省科技厅资助项目(YDZJ202202CXJD035)。
关键词 脑梗死 残端综合征 诊断 血管内治疗 Cerebral infarction Stump syndrome Diagnosis Endovascular treatment
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