[急性缺血性卒中治疗管理的新选择。静脉内和动脉内联合溶栓及机械取栓取得良好效果]
[New options in the therapeutic management of acute ischaemic stroke. Good results with combined i. v. and i. a. lysis and mechanical thrombectomy].
作者信息
Venker C, Stracke P, Berlit P, Diehl R R, Kurre W, Sorgenfrei U, Krämer M, Chapot R
机构信息
Klinik für Neurologie, Alfried-Krupp Krankenhaus, Essen.
出版信息
Fortschr Neurol Psychiatr. 2010 Nov;78(11):652-7. doi: 10.1055/s-0029-1245582. Epub 2010 Nov 10.
BACKGROUND
Standard therapy for acute ischaemic stroke is the intravenous thrombolysis with rtPA. A combined therapy with intravenous bridging and consecutive intraarterial thrombolysis and mechanical thrombectomy is a relatively new option in patients with proximal vessel occlusion.
PATIENTS AND METHODS
10 Patients with a CTA proven proximal vessel occlusion in the anterior circulation (ACI, carotis bifurcation, MCA) in CTA were treated with a combined therapy with i. v. and i. a. thrombolysis and thrombectomy with a Solitaire FR stent device.
RESULTS
All Patients were recanalized, the NIHSS changed from 15.6 to 3.3. 8 out of 10 patients had nearly no symptoms when dismissed. There were no direct therapeutic complications.
CONCLUSION
Combined therapy with i. v. and i. a. thrombolysis and thombectomy with the Solitaire FR stent device is a promising option in patients with acute proximal vessel occlusion in the anterior circulation.
背景
急性缺血性卒中的标准治疗方法是静脉注射rtPA进行溶栓。对于近端血管闭塞的患者，静脉桥接联合后续动脉内溶栓和机械取栓的联合治疗是一种相对较新的选择。
患者与方法
10例经CTA证实前循环（颈内动脉、颈动脉分叉、大脑中动脉）近端血管闭塞的患者接受了静脉和动脉溶栓以及使用Solitaire FR支架装置进行取栓的联合治疗。
结果
所有患者血管均再通，美国国立卫生研究院卒中量表（NIHSS）评分从15.6降至3.3。10例患者中有8例出院时几乎没有症状。未出现直接治疗并发症。
结论
静脉和动脉溶栓以及使用Solitaire FR支架装置进行取栓的联合治疗对于前循环急性近端血管闭塞的患者是一种有前景的选择。
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