急性重症后循环缺血性脑卒中血管内治疗临床疗效观察
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摘要
目的探讨急性重症后循环缺血性脑卒中血管内治疗的临床疗效及安全性。方法选取辽宁省人民医院神经内科急诊自2016年1月1日至2017年12月31日收治的39例重症后循环缺血性卒中患者为研究对象。根据治疗方式的不同将其分为血管内治疗组(n=24)与标准药物治疗组(n=15)。观察并比较两组患者的临床疗效。结果血管内治疗组的血管再通率为91.7%(22/24),显著高于标准药物治疗组的26.7%(4/15),两组间比较,差异有统计学意义(P<0.05);血管内治疗组的总有效率为58.3%(14/24),显著高于标准药物治疗组的26.7%(4/15),两组间比较,差异有统计学意义(P<0.05)。结论与标准药物治疗比较,血管内治疗急性重症后循环缺血性脑卒中患者疗效更为显著,可降低患者严重致残率。
Objective To investigate the clinical efficacy and safety of endovascular therapy for acute severe posterior circulation ischemic stroke.Methods A retrospective study was performed on 39 cases of patients with severe posterior circulation ischemic stroke who were admitted from January 1,2016 to December 31,2017.Patients were divided into the endovascular treatment group(n=24) and standard drug treatment group(n=15) according to different treatment methods.The clinical efficacy of the two groups was observed and compared.Results The vascular recanalization rate of the endovascular treatment group was 91.7%(22/24),significantly higher than that of the standard drug treatment group 26.7%(4/15),and the difference between the two groups was statistically significant(P<0.05).The total effective rate of the endovascular treatment group was 58.3%(14/24),significantly higher than that of the standard drug treatment group 26.7%(4/15),(P<0.05).Conclusion Compared with standard drug therapy,endovascular treatment of acute severe posterior circulation ischemic stroke has a more significant effect,which can reduce the serious disability rate of patients.
Objective To investigate the clinical efficacy and safety of endovascular therapy for acute severe posterior circulation ischemic stroke.Methods A retrospective study was performed on 39 cases of patients with severe posterior circulation ischemic stroke who were admitted from January 1,2016 to December 31,2017.Patients were divided into the endovascular treatment group(n=24) and standard drug treatment group(n=15) according to different treatment methods.The clinical efficacy of the two groups was observed and compared.Results The vascular recanalization rate of the endovascular treatment group was 91.7%(22/24),significantly higher than that of the standard drug treatment group 26.7%(4/15),and the difference between the two groups was statistically significant(P<0.05).The total effective rate of the endovascular treatment group was 58.3%(14/24),significantly higher than that of the standard drug treatment group 26.7%(4/15),(P<0.05).Conclusion Compared with standard drug therapy,endovascular treatment of acute severe posterior circulation ischemic stroke has a more significant effect,which can reduce the serious disability rate of patients.
引文
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[9] Miteff F,Faulder KC,Goh AC,et al.Mechanical thrombectomy with a self-expanding retrievable intracranial stent (solitaire AB):experience in 26 patients with acute cerebral artery occlusion[J].AJNR Am J Neuroradiol,2011,32(6):1078-1081.
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[11] Mordasini P,Brekenfeld C,Byrne JV,et al.Technical feasibility and application of mechanical thrombectomy with the solitaire FR revascularization device in acute basilar artery occlusion[J].AJNR Am J Neuroradiol,2013,34(1):159-163.
[12] Espinosa de Rueda M,Parrilla G,Zamarro J,et al.Treatment of acute vertebrobasilar occlusion using thrombectomy with stent retrievers:initial experience with 18 patients[J].AJNR Am J Neuroradiol,2013,34(5):1044-1048.
[13] Mohlenbruch M,Stampfl S,Behrens L,et al.Mechanical thrombectomy with stent retrievers in acute basilar artery occlusion[J].AJNR Am J Neuroradiol,2014,35(5):959-964.
[14] Gory B,Mazighi M,Blanc R,et al.Mechanical thrombectomy in basilar artery occlusion:influence of reperfusion on clinical outcome and impact of the first-line strategy (ADAPT vs stent retriever)[J].J Neurosurg,2018,129(6):1482-1491.
[15] Puetz V,Sylaja PN,Coutts SB,et al.Extent of hypoattenuation on CT angiography source images predicts functional outcome in patients with basilar artery occlusion[J].Stroke,2008,39(9):2485-2490.
[16] Janssen H,Brückmann H,Killer M,et al.Acute basilar thrombosis:recanalization following intravenous thrombolysis is dependent on thrombus length[J].PLoS One,2018,13(2):e0193051.
[2] 李贵福,马朝晖,罗望池,等.Solitaire AB型支架用于急性脑动脉闭塞取栓术31例[J].介入放射学杂志,2012,21(2):98-102.
[3] Schonewille WJ,Wijman CA,Michel P,et al.Treatment and outcomes of acute basilar artery occlusion in the basilar artery international cooperation study (BASICS):a prospective registry study[J].Lancet Neurol, 2009,8(8):724-730.
[4] Bergui M,Stura G,Daniele D,et al.Mechanical thrombolysis in ischemic stroke attributable to basilar artery occlusion as first-line treatment[J].Stroke,2006,37(1):145-150.
[5] Chapot R,Houdart E,Rogopoulos A,et al.Thromboaspiration in the basilar artery:report of two cases[J].AJNR Am J Neuroradiol,2002,23(2):282-284.
[6] Mohlenbruch M,Seifert M,Okulla T,et al.Mechanical thrombectomy compared to local-intraarterial thrombolysis in carotidTand middle cerebral artery occlusions:a single center experience[J].Clin Neuroradiol,2012,22(2):141-147.
[7] Stampfl S,Hartmann M,Ringleb PA,et al.Stent placement for flow restoration in acute ischemic stroke:a single-center experience with the solitaire stent system[J].AJNR Am J Neuroradiol,2011,32(7):1245-1248.
[8] Rohde S,Haehnel S,Herweh C,et al.Mechanical thrombectomy in acute embolic stroke:preliminary results with the revive device[J].Stroke,2011,42(10):2954-2956.
[9] Miteff F,Faulder KC,Goh AC,et al.Mechanical thrombectomy with a self-expanding retrievable intracranial stent (solitaire AB):experience in 26 patients with acute cerebral artery occlusion[J].AJNR Am J Neuroradiol,2011,32(6):1078-1081.
[10] Dorn F,Stehle S,Lockau H,et al.Endovascular treatment of acute intracerebral artery occlusions with the Solitaire stent:single-centre experience with 108 recanalization procedures[J].Cerebrovasc Dis,2012,34(1):70-77.
[11] Mordasini P,Brekenfeld C,Byrne JV,et al.Technical feasibility and application of mechanical thrombectomy with the solitaire FR revascularization device in acute basilar artery occlusion[J].AJNR Am J Neuroradiol,2013,34(1):159-163.
[12] Espinosa de Rueda M,Parrilla G,Zamarro J,et al.Treatment of acute vertebrobasilar occlusion using thrombectomy with stent retrievers:initial experience with 18 patients[J].AJNR Am J Neuroradiol,2013,34(5):1044-1048.
[13] Mohlenbruch M,Stampfl S,Behrens L,et al.Mechanical thrombectomy with stent retrievers in acute basilar artery occlusion[J].AJNR Am J Neuroradiol,2014,35(5):959-964.
[14] Gory B,Mazighi M,Blanc R,et al.Mechanical thrombectomy in basilar artery occlusion:influence of reperfusion on clinical outcome and impact of the first-line strategy (ADAPT vs stent retriever)[J].J Neurosurg,2018,129(6):1482-1491.
[15] Puetz V,Sylaja PN,Coutts SB,et al.Extent of hypoattenuation on CT angiography source images predicts functional outcome in patients with basilar artery occlusion[J].Stroke,2008,39(9):2485-2490.
[16] Janssen H,Brückmann H,Killer M,et al.Acute basilar thrombosis:recanalization following intravenous thrombolysis is dependent on thrombus length[J].PLoS One,2018,13(2):e0193051.