机械取栓治疗伴椎基底动脉闭塞的轻型卒中2例分析
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摘要
目的:探讨机械取栓治疗伴椎基底动脉闭塞的后循环轻型卒中的有效性及安全性。方法:通过对2例伴椎基底动脉闭塞轻型卒中患者进行机械取栓治疗,并引用文献进行分析,探讨该治疗方法的有效性及安全性。结果:2例合并椎基底动脉闭塞的轻型卒中通过机械取栓治疗均取得良好的效果,未出现明显的并发症。结论:对合并椎基底动脉闭塞的轻型卒中进行机械取栓治疗安全有效;治疗过程中准确评估血栓长度及部位,采取综合措施再通血管同时防止血栓远端脱落是最关键的治疗要素。
Objective: To explore the safety and effectiveness of mechanical thrombectomy for posterior circulation mild stroke with vertebral basilar artery occlusion. Methods : Two cases of mild stroke with vertebral basilar artery occlusion were diagnosed and treated by mechanical thrombectomy, and the literature was cited to analyze the effectiveness and safety of the modified treatment. Results : Mechanical thrombectomy in 2 cases with vertebral basilar artery occlusion achieved good results without obvious complications. Conclusions: Mechanical thrombectomy for mild stroke combined with vertebral basilar artery occlusion is safe and effective. Accurate assessment of the length and location of thrombus, comprehensive measures to revascularization and prevention of distal thrombosis are the most critical therapeutic factors.
Objective: To explore the safety and effectiveness of mechanical thrombectomy for posterior circulation mild stroke with vertebral basilar artery occlusion. Methods : Two cases of mild stroke with vertebral basilar artery occlusion were diagnosed and treated by mechanical thrombectomy, and the literature was cited to analyze the effectiveness and safety of the modified treatment. Results : Mechanical thrombectomy in 2 cases with vertebral basilar artery occlusion achieved good results without obvious complications. Conclusions: Mechanical thrombectomy for mild stroke combined with vertebral basilar artery occlusion is safe and effective. Accurate assessment of the length and location of thrombus, comprehensive measures to revascularization and prevention of distal thrombosis are the most critical therapeutic factors.
引文
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[2]Kim JT,Park MS,Choi KH,et al.Clinical outcomes of posterior versus anterior circulation infarction with low national institutes of health stroke scale scores[J].Stroke,2016,48(10):55-62.
[3]Goyal M,Menon BK,van Zwam WH,et al.Endovascular thrombectomy after large-vessel ischaemic stroke:a meta-analysis of individual patient data from five randomised trials[J].Lancet,2016,387(10029):1723-1731.
[4]Dargazanli C,Arquizan C,Gory B,et al.Mechanical thrombectomy for minor and mild stroke patients harboring large vessel occlusion in the anterior circulation:A multicenter cohort study[J].Stroke,2017,48(12):3274-3281.
[5]Sato S,Uehara T,Ohara T,et al.Factors associated with unfavorable outcome in minor ischemic stroke[J].Neurology,2014,83(2):174-181.
[6]Miteff F,Levi CR,Bateman GA,et al.The independent predictive utility of computed tomography angiographic collateral status in acute ischaemic stroke[J].Brain,2009,132(8):2231-2238.
[7]陈健,焦力群,李桂林,等.机械取栓治疗急性大动脉闭塞性轻型卒中[J].中华神经外科杂志,2018,34(3):231-234.
[8]Urra X,San Román L,Gil F,et al.Medical and endovascular treatment of patients with large vessel occlusion presenting with mild symptoms:an observational multicenter study[J].Cerebrovasc Dis,2014,38(6):418-424.
[9]Haussen DC,Bouslama M,Grossberg JA,et al.Too good to intervene?Thrombectomy for large vessel occlusion strokes with minimal symptoms:an intention-to-treat analysis[J].J Neurointerv Surg,2017,9(10):917-921.