针对延迟性基底动脉支架闭塞进行血栓切除术，效果良好。
Thrombectomy for delayed basilar stent occlusion with good outcome.
作者信息
Janjua Nazli, Farkas Jeffrey
机构信息
Asia Pacific Comprehensive Stroke Institute, Claremont, CA, USA ; Department of Radiology, Lutheran Medical Center, Brooklyn, NY, USA.
Department of Radiology, Lutheran Medical Center, Brooklyn, NY, USA.
出版信息
J Vasc Interv Neurol. 2013 Dec;6(2):19-24.
ABSTRACT
Neurovascular stents have revolutionized the endovascular treatment of wide-necked and fusiform aneurysms; however, potential in-stent thrombosis-resulting in devastating strokes-complicates their use. Interventionalists using these devices must be aware of treatment options for such events. We present the case of a 46-year-old man who underwent stent-supported embolization of an incidental basilar aneurysm followed by in-stent thrombosis 6 weeks later. Though he presented at that time after 24 h of symptom onset with complete occlusion of the basilar artery, delayed thrombectomy and thrombolysis resulted in a good clinical outcome.
LIST OF ABBREVIATIONS
IVintravenousACTactivated coagulation timeDWI MRIdiffusion weighted magnetic resonance imagingIAintra-arterialtPAtissue plasminogen activatorICHintracranial hemorrhage.
LIST OF PROPRIETARY DEVICES CITED IN TEXT
Enterprise Vascular Reconstructive Device ®, Codman Neurovascular, Raynham, MA Excelsior SL 10 microcatheter, Target Therapeutics/Stryker, Fremont, CA Prowler Plus Select microcatheter, Codman Neurovascular MPD Envoy catheter, Codman Neurovascular Penumbra .032" Reperfusion catheter, Penumbra Inc., San Leandro, CA Transend .014" microwire, Target/Stryker Merci Concentric Retriever ®, Concentric Medical/Stryker, Mountainview, CA.
摘要
神经血管支架彻底改变了宽颈和梭形动脉瘤的血管内治疗方式；然而，支架内潜在血栓形成会导致灾难性中风，使支架的使用变得复杂。使用这些装置的介入医生必须了解针对此类事件的治疗选择。我们报告一例46岁男性病例，该患者接受了支架辅助栓塞偶然发现的基底动脉瘤，6周后发生支架内血栓形成。尽管他在症状出现24小时后就诊时基底动脉已完全闭塞，但延迟性血栓切除术和溶栓治疗取得了良好的临床效果。
缩略词列表
IV静脉内；ACT活化凝血时间；DWI MRI弥散加权磁共振成像；IA动脉内；tPA组织型纤溶酶原激活剂；ICH颅内出血。
文中引用的专有装置列表
Enterprise血管重建装置®，Codman神经血管公司，马萨诸塞州雷纳姆；Excelsior SL 10微导管，Target Therapeutics/Stryker公司，加利福尼亚州弗里蒙特；Prowler Plus Select微导管，Codman神经血管公司；MPD Envoy导管，Codman神经血管公司；Penumbra 0.032英寸再灌注导管，Penumbra公司，加利福尼亚州圣莱安德罗；Transend 0.014英寸微导丝，Target/Stryker公司；Merci同心取栓器®，Concentric Medical/Stryker公司，加利福尼亚州山景城。
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