導(dǎo)絲留置技術(shù)在急性腦動脈閉塞機械取栓中的應(yīng)用
發(fā)布時間:2018-04-10 09:54
本文選題:急性缺血性腦卒中 切入點:機械取栓 出處:《介入放射學(xué)雜志》2017年03期
【摘要】:目的探討導(dǎo)絲留置技術(shù)在急性腦動脈閉塞機械取栓術(shù)中的應(yīng)用價值、安全性及可行性。方法回顧分析2015年10月至2016年2月采用機械取栓治療的15例急性缺血性腦卒中患者臨床資料,其中大腦中動脈閉塞6例,頸內(nèi)動脈及大腦中動脈閉塞5例,椎基底動脈閉塞4例。采用導(dǎo)絲留置技術(shù)快速準(zhǔn)確判斷血管閉塞特征,進行血管內(nèi)機械取栓術(shù)治療。結(jié)果 15例患者經(jīng)導(dǎo)絲留置技術(shù)均成功準(zhǔn)確判斷病變血管閉塞特征。13例(87%)閉塞血管即刻再通,其中10例腦梗死溶栓后血流分級(TICI)評分達(dá)3分,5例2b分;2例因血栓負(fù)荷量大、閉塞節(jié)段長,多次取栓效果不佳,血管再通失敗。美國國立衛(wèi)生研究院卒中量表(NIHSS)評分由術(shù)前19.2±7.0改善至術(shù)后1周6.3±3.6,差異有統(tǒng)計學(xué)意義(P0.01)。術(shù)后3個月10例改良Rankin量表(m RS)評分≤2分。結(jié)論機械取栓治療急性腦血管閉塞安全有效,導(dǎo)絲留置技術(shù)可安全、方便快捷、準(zhǔn)確地判斷出閉塞血管特征,減少手術(shù)操作,降低手術(shù)并發(fā)癥,提高血管再通率。
[Abstract]:Objective to investigate the value, safety and feasibility of wire guide indwelling technique in mechanical thrombectomy for acute cerebral artery occlusion.Methods the clinical data of 15 patients with acute ischemic stroke treated by mechanical thrombectomy from October 2015 to February 2016 were retrospectively analyzed, including 6 cases of middle cerebral artery occlusion, 5 cases of internal carotid artery occlusion and 5 cases of middle cerebral artery occlusion.Vertebrobasilar artery occlusion in 4 cases.The technique of wire guide indwelling was used to judge the characteristics of vascular occlusion quickly and accurately, and the intravascular mechanical thrombectomy was performed.Results all of the 15 patients were correctly diagnosed by the technique of guiding wire indwelling. 13 patients with occlusive vessel were immediately recanalized. Among them, 10 patients with thrombolytic thrombolytic thrombolytic blood flow grading (TICI) score of 5 patients were 3 points, 2 patients had high thrombus load, 2 patients had high thrombus load, 2 patients had high thrombus load, and 5 patients had high thrombus load after thrombolytic thrombolysis.The segment of occlusion was long, the effect of multiple embolization was not good, and the recanalization of blood vessel failed.The NIHSS score was improved from 19.2 鹵7.0 before operation to 6.3 鹵3.6 at 1 week postoperatively. The difference was statistically significant (P 0.01).The score of modified Rankin scale was 鈮,
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