优化救治流程与Solitaire FR支架在治疗急性脑动脉闭塞中的应用

doi:10.6040/j.issn.1671-7554.0.2017.156

摘要/Abstract

摘要： 目的探讨在优化救治流程中,应用支架取栓的方法治疗急性脑动脉闭塞(ACAO)的效果及安全性。方法回顾2013年1月至2016年12月进入优化救治流程中应用Solitaire FR支架取栓方法治疗的36例ACAO患者,血管再通标准采用mTICI分级,临床效果及预后采用美国国立卫生研究院卒中量表(NIHSS)评分,以及90 d改良Rankin评分(mRS)评价其疗效及安全性。结果 33例患者经血管内治疗后均成功开通闭塞血管(mTICI 2b-3),2例患者经治疗后血管部分再通(mTICI 2a),1例患者仅有微量血流通过闭塞段(mTICI 1)。术前及术后NIHSS评分相比,差异有统计学意义(P<0.05)。术后90 d改良Rankin评分(mRS)显示预后良好。其中0分5例,1分24例,2分4例,1例失访,2例死亡。33例患者随访期内复查无血管再闭塞,无症状性脑出血并发症。结论应用机械取栓治疗ACAO是安全、有效的,但应严格把握适应证及禁忌证。

关键词: 机械取栓, 疗效, 急性脑动脉闭塞, 大血管闭塞, 血管内治疗

Abstract: Objective To explore the effectiveness and safety of Solitaire FR stent in the optimized treatment of acute cerebral artery occlusion(ACAO). Methods Data of 36 ACAO cases treated with Solitaire FR stent mechanical thrombectomy during Jan. 2013 and Dec. 2016 were retrospectively analyzed. The recanalization rate was assessed with mTICI score, the clinical outcome was evaluated with NIHSS score, and the clinical efficacy and safety were determined with modified Rankin Score(mRS). Results Altogether 33 patients achieved successful recanalization(TICI 2b-3), 2 patients had partial recanalization(mTICI 2a), and 1 patient had slight recanalization(mTICI 1). The NIHSS score was significantly lower after operation(P<0.05). The 90-day mRS indicated satisfactory prognosis. The mRS was 0 in 5 patients, 1 in 24 patients, and 2 in 4 patients. One patient was loss of follow-up, and 2 patients died during the follow-up. No vessel occlusion or asymptomatic cerebral hemorrhage were observed in the other 33 patients. 山东大学学报 (医学版)55卷7期 -颜进项,等.优化救治流程与Solitaire FR支架在治疗急性脑动脉闭塞中的应用 \=- Conclusion Endovascular therapy of acute cerebral artery occlusion is safe and effective, but the indications and contraindications should be strictly observed.

Key words: Endovascular therapy, Mechanical thrombectomy, Efficacy, Acute cerebral artery occlusion, Large vessel occlusion

中图分类号:

R743.3

颜进项,孟雷,董亚南,张爱军,岳洪胜,李波,钟良君,白爱国. 优化救治流程与Solitaire FR支架在治疗急性脑动脉闭塞中的应用[J]. 山东大学学报（医学版）, 2017, 55(7): 49-54.

YAN Jinxiang, MENG Lei, DONG Yanan, ZHANG Aijun, YUE Hongsheng, LI Bo, ZHONG Liangjun, BAI Aiguo. Application of Solitaire FR stent in the optimized treatment of acute cerebral artery occlusion[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(7): 49-54.

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