超声引导下V3段椎动脉直接经皮穿刺用于急性卒中基底动脉机械取栓：技术报告
Ultrasound guided V3 segment vertebral artery direct percutaneous puncture for basilar artery mechanical thrombectomy in acute stroke: a technical report.
作者信息
Desai Jamsheed A, Almekhlafi Mohammed A, Hill Michael D, Goyal Mayank, Eesa Muneer
机构信息
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
出版信息
BMJ Case Rep. 2013 Mar 27;2013:bcr2012010601. doi: 10.1136/bcr-2012-010601.
Abstract
A middle aged patient presented with acute ischemic stroke due to basilar artery occlusion. The patient clinically deteriorated despite intravenous thrombolysis and was referred for mechanical thrombectomy. The right vertebral artery was occluded and could not be accessed despite attempting various shaped catheters, even when a radial artery access was used. The left vertebral artery ended in the posterior inferior cerebellar artery. Eventually, ultrasound guided V3 segment vertebral artery direct puncture was successfully done and the procedure was completed. No access related complications were encountered. Direct cervical arterial puncture can be safely used by experienced operators as a last resort in acute stroke cases with difficult access.
摘要
一名中年患者因基底动脉闭塞出现急性缺血性卒中。尽管进行了静脉溶栓治疗，但患者临床症状仍恶化，遂被转诊进行机械取栓术。右侧椎动脉闭塞，尽管尝试了各种形状的导管，甚至使用了桡动脉入路，仍无法进入。左侧椎动脉终止于小脑后下动脉。最终，成功完成了超声引导下V3段椎动脉直接穿刺，并完成了手术。未遇到与入路相关的并发症。经验丰富的操作人员可将直接颈动脉穿刺作为急性卒中入路困难病例的最后手段安全使用。
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