临床荟萃 ›› 2021, Vol. 36 ›› Issue (1): 30-34.doi: 10.3969/j.issn.1004-583X.2021.01.006

• 论著 • 上一篇    下一篇

颈内动脉颅内段慢性闭塞血管内开通术的临床分析

徐耀铭1, 杜艳秋1, 缪中荣2, 高峰2()   

  1. 1.通辽市医院 神经内科, 内蒙古自治区 通辽 028000
    2.首都医科大学附属北京天坛医院 神经介入中心, 北京 100053
  • 收稿日期:2020-09-23 出版日期:2021-01-20 发布日期:2021-01-16
  • 通讯作者: 高峰 E-mail:gaofengletter@sina.com
  • 基金资助:
    北京市科委“首都临床特色应用研究”专项课题——颅内动脉闭塞性疾病血管内治疗策略选择及优化流程的临床研究(Z18110000171837)

Clinical analysis of endovascular recanalization for chronic intracranial segment of intracranial artery occlusion

Xu Yaoming1, Du Yanqiu1, Miu Zhongrong2, Gao Feng2()   

  1. 1. Department of Neurology, Tongliao Hospital, Tongliao 0280002, China
    2. Department of Neurointervention, Beijing Tiantan Hospital, Capital Medical University, Beijing 100053, China
  • Received:2020-09-23 Online:2021-01-20 Published:2021-01-16
  • Contact: Gao Feng E-mail:gaofengletter@sina.com

摘要:

目的 探讨血管内再通术治疗症状性颈内动脉颅内段慢性闭塞的安全性和有效性。方法 对颈内动脉颅内段慢性闭塞患者行血管内再通术治疗的患者9例,闭塞部位在颈内动脉C6-C7段,其中8例再通患者中全部使用了扩张球囊,其中2例使用球扩支架,6例使用自膨支架,收集全部患者的临床资料、影像学及随访资料进行回顾分析。结果 从首次发病到介入再通时间21~ 43天,中位时间29天,9例患者中 1例因导丝不能通过而结束手术,技术成功率89.1%(8/9),术后1例患者出现治疗侧可逆性视网膜中央动脉栓塞,无高灌注并发症,无死亡病例。随访3~12月,1例患者出现支架内轻度再狭窄(狭窄度30%),再狭窄率为11%,无卒中事件发生。 结论 血管内再通术治疗颈内动脉颅内段慢性闭塞安全可行,手术成功率高,经严格筛选标准下可以在临床上推广。

关键词: 动脉闭塞性疾病, 颈内动脉颅内段, 血管再通术

Abstract:

Objective To evaluate the safety and efficacy of endovascular recanalization in the treatment of chronic occlusion of symptomatic internal carotid artery.Methods Chronic intracranial internal carotid artery occlusion endovascular recanalization treatment of 9 cases of patients, in the internal carotid artery occlusion parts C6-C7 segment, 8 cases of recanalization in patients with all used the balloon expansion, including 2 cases using ball expand stents, 6 cases since used of stents, collection was involved all of the patient's clinical information, imaging, and follow-up data were analyzed retrospectively. Results The time from first onset to interventional recanalization was 21-43 days, median 29 days. One of the 9 patients ended the operation because the guide wire failed. The technical success rate was 89.1%(8/9).After surgery, one patient had a reversible central retinal arterial embolization on the treatment side, and there was no high perfusion complication and no death.During 3-12 months of follow-up, one patient developed mild restenosis within the stent (stenosis 30%), and the restenosis rate was 11%, no stroke occurred.Conclusion Endovascular recanalization is safe and feasible in the treatment of chronic occlusion of the internal carotid artery in the intracranial segment, with a high surgical success rate, and can be promoted clinically under strict screening criteria.

Key words: arterial occlusive diseases, intracranial segment of internal carotid artery, recanalization

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