摘要
目的探讨颈内动脉颅外段起始部急性闭塞的不同开通策略及其可行性。方法回顾性分析2015年5月至2018年1月收治的15例颈内动脉起始段急性闭塞患者临床资料。分别采用不同方法(微导管+微导丝、小球囊+微导丝、多功能管+超滑导丝)开通闭塞段,对开通策略制定、手术器械选择及其开通效果进行初步评估。结果 15例患者均成功开通闭塞段血管,发生远端栓塞事件2例。术后90 d随访均恢复良好,无明显后遗症状。结论对于颈内动脉急性闭塞,手术策略上既要提高开通成功率,尽量缩短开通时间,更要兼顾手术安全。微导管、导丝配合通过病变方法应作为首选,但在特殊条件下其它开通方式可作为补充。
Objective To discuss the clinical effect and feasibility of various vascular recanalization techniques in treating acute occlusion of the initial site of extracranial segment of internal carotid artery(ICA). Methods The clinical data of 15 patients with acute occlusion of the initial site of extracranial segment of ICA, who were admitted to authors' hospital during the period from May 2015 to January 2018,were retrospectively analyzed. Different methods, including use of microcatheter plus microguidewire, use of small balloon plus microguidewire, use of multifunctional catheter plus supersmooth wire, were separately adopted to complete the recanalization procedure for occluded vascular segment. The formulation of the recanalization strategy, the selection of surgical instruments, and the therapeutic effect of each recanalization strategy were assessed. Results Successful recanalization of occluded vascular segment was achieved in all15 patients. Distal embolism event occurred in 2 patients. All patients recovered well at 90 days after the treatment, and no obvious sequelae were observed. Conclusion For the treatment of acute ICA occlusion,the formulation of surgical strategy should not only improve the recanalization rate and shorten the operation time as far as possible, but also more attention should be paid to the safety of surgery. The microcatheter plus microguidewire method should be the first choice, and under special conditions other vascular recanalization techniques can be used as a supplement.(J Intervent Radiol, 2019, 28: 312-315)
引文
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