Wang Liang, Shi Wanchao, Su Zhiguo, Liu Xiaozhi, Su Hua, Liu Jun, Liu Zhenlin, Lawton Michael T
Department of Neurosurgery, Tianjin 5th Center Hospital, 41 Zhenjiang Road, Tanggu District, Tianjin 300450, China.
Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA.
J Clin Neurosci. 2015 Jan;22(1):195-8. doi: 10.1016/j.jocn.2014.05.032. Epub 2014 Oct 28.
Severe acute basilar artery occlusion (BAO) has a high mortality rate but as yet no effective treatment has been developed. This study aimed to evaluate the feasibility and safety of combined mechanical thrombectomy, intra-arterial thrombolysis, and emergent stent placement for patients with severe acute BAO. Eighteen patients who were unconscious after confirmed onset of BAO and who were given arterial interventional treatment from March 2011 to June 2013 at our department were included in this study. The mean age was 59.56 years (range: 31-76 years) and patients were in a critical physical condition upon admission, and had a mean National Institutes of Health Stroke Scale (NIHSS) score of 25.94 (range: 18-35). All patients were treated with mechanical thrombectomy, 10 of whom received mechanical thrombectomy only. Of the others, eight were also treated with intra-arterial thrombolysis, three were treated with emergent stent placement, and 17 were treated with recanalization with an achieved recanalized rate of 94.4%. The average number of passes through the stent was 1.5 (range: 1-3) and five patients died (27.8%). Thirteen patients survived, and the mean NIHSS score was 6.54 (range: 0-16). Seven patients showed a modified Rankin Scale score ⩽ 2, and the rate of good prognoses was 38.9%. In the treatment of patients with severe acute BAO, intra-arterial mechanical thrombectomy combined with thrombolysis or stent placement are effective strategies to restore blood flow and preserve life, and these strategies have a low incidence of complications.
严重急性基底动脉闭塞（BAO）死亡率高，但目前尚未开发出有效的治疗方法。本研究旨在评估联合机械取栓、动脉内溶栓和急诊支架置入术治疗严重急性BAO患者的可行性和安全性。本研究纳入了2011年3月至2013年6月在我科确诊BAO发作后昏迷并接受动脉介入治疗的18例患者。平均年龄为59.56岁（范围：31 - 76岁），患者入院时身体状况危急，美国国立卫生研究院卒中量表（NIHSS）平均评分为25.94（范围：18 - 35）。所有患者均接受机械取栓治疗，其中10例仅接受机械取栓治疗。其余患者中，8例还接受了动脉内溶栓治疗，3例接受了急诊支架置入术，17例实现再通，再通率为94.4%。通过支架的平均次数为1.5次（范围：1 - 3次），5例患者死亡（27.8%）。13例患者存活，NIHSS平均评分为6.54（范围：0 - 16）。7例患者改良Rankin量表评分≤2，良好预后率为38.9%。在严重急性BAO患者的治疗中，动脉内机械取栓联合溶栓或支架置入术是恢复血流和挽救生命的有效策略，且这些策略并发症发生率低。
