经皮直接颈动脉穿刺通路在急性缺血性卒中血管内治疗中的应用：技术要点、优势及局限性
Direct carotid artery puncture access for endovascular treatment of acute ischemic stroke: technical aspects, advantages, and limitations.
作者信息
Mokin Maxim, Snyder Kenneth V, Levy Elad I, Hopkins L Nelson, Siddiqui Adnan H
机构信息
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, New York, USA.
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA Department of Neurosurgery, Gates Vascular Institute, Kaleida Health, Buffalo, New York, USA Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA Department of Radiology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York, USA.
出版信息
J Neurointerv Surg. 2015 Feb;7(2):108-13. doi: 10.1136/neurintsurg-2013-011007. Epub 2014 Jan 9.
BACKGROUND
Challenging anatomy for carotid artery access can result in a delay to achieve successful recanalization in patients with acute ischemic stroke. Our objective was to study emergent direct percutaneous carotid artery puncture as an alternative access approach for acute endovascular stroke interventions.
METHODS
We reviewed cases of acute ischemic stroke in which direct carotid artery puncture was used for access. We also reviewed current literature relevant to this subject.
RESULTS
We describe the technical aspects, limits, and potential complications associated with direct carotid artery puncture for intracranial acute ischemic stroke interventions, and present cases to illustrate the utility of this access approach.
CONCLUSIONS
Direct carotid artery puncture is a feasible alternative to transfemoral artery access in cases of stroke with difficult anatomy, including unfavorable arch type, carotid tortuosity, or an ostial lesion.
背景
颈动脉穿刺入路面临的解剖结构挑战可能导致急性缺血性脑卒中患者成功再通延迟。我们的目的是研究紧急直接经皮颈动脉穿刺作为急性血管内卒中干预的替代入路方法。
方法
我们回顾了使用直接颈动脉穿刺进行入路的急性缺血性脑卒中病例。我们还回顾了与该主题相关的当前文献。
结果
我们描述了与颅内急性缺血性卒中干预直接颈动脉穿刺相关的技术方面、局限性和潜在并发症，并展示病例以说明这种入路方法的实用性。
结论
在解剖结构复杂的卒中病例中，包括弓型不佳、颈动脉迂曲或开口病变，直接颈动脉穿刺是经股动脉入路的可行替代方法。
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