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椎动脉夹层再通。

Recanalization of vertebral artery dissection.

机构信息

Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco, Suárez, Mexico City, Mexico.

出版信息

Stroke. 2010 Apr;41(4):717-21. doi: 10.1161/STROKEAHA.109.568790. Epub 2010 Feb 11.

Abstract

BACKGROUND AND PURPOSE

We investigated the predictors and time course for recanalization after vertebral artery dissection.

METHODS

We prospectively studied 61 consecutive patients with confirmed diagnoses of vertebral artery dissection without intracerebral hemorrhage. Neuroimaging and clinical follow-up were performed at presentation and at 3, 6, and 12 months.

RESULTS

We included 61 patients with confirmed vertebral artery dissection; 19 were evaluated and followed up with conventional angiography, 24 with MR angiography, and 18 with CT angiography. Fifty-one patients had a stenotic dissection, 7 had an occlusive dissection, one had a double-lumen image, and 2 had a pseudoaneurysm. The estimated rate of complete recanalization after vertebral artery dissection was 45.9% at 3 months, 62.3% at 6 months, and 63.9% at 12 months. We found no association between outcome and complete or partial recanalization nor did we find any factors associated with recanalization.

CONCLUSIONS

These results suggest that recanalization of vertebral artery dissection occurs mainly within the first 6 months after the onset of symptoms regardless of the location or pattern of the dissection.

摘要

背景与目的

我们研究了椎动脉夹层后再通的预测因素和时间进程。

方法

我们前瞻性研究了 61 例经证实的无颅内出血的椎动脉夹层患者。在发病时、3 个月、6 个月和 12 个月进行神经影像学和临床随访。

结果

我们共纳入 61 例经证实的椎动脉夹层患者;19 例接受常规血管造影评估和随访,24 例接受磁共振血管造影评估,18 例接受 CT 血管造影评估。51 例为狭窄性夹层,7 例为闭塞性夹层,1 例为双腔图像,2 例为假性动脉瘤。椎动脉夹层后完全再通的估计率为 3 个月时 45.9%,6 个月时 62.3%,12 个月时 63.9%。我们发现再通结局与完全或部分再通之间无相关性,也未发现任何与再通相关的因素。

结论

这些结果表明,椎动脉夹层的再通主要发生在症状出现后的前 6 个月内,无论夹层的位置或类型如何。

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