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机械取栓术中发生脑动脉气体栓塞:高压氧治疗后的恢复情况

Cerebral arterial gas embolism from attempted mechanical thrombectomy: recovery following hyperbaric oxygen therapy.

作者信息

Segan Louise, Permezel Fiona, Ch'ng Wei, Millar Ian, Brooks Mark, Lee-Archer Matt, Cloud Geoffrey

机构信息

Department of Stroke Services, Alfred Hospital, Melbourne, Victoria, Australia.

Department of Neurology, Austin Hospital, Heidelberg, Victoria, Australia.

出版信息

Pract Neurol. 2018 Apr;18(2):134-136. doi: 10.1136/practneurol-2017-001828. Epub 2017 Dec 28.

Abstract

Cerebral arterial gas embolism is a recognised complication of endovascular intervention with an estimated incidence of 0.08%. Its diagnosis is predominantly clinical, supported by neuroimaging. The treatment relies on alleviating mechanical obstruction and reversing the proinflammatory processes that contribute to tissue ischaemia. Hyperbaric oxygen therapy is an effective treatment and has multiple mechanisms to reverse the pathological processes involved in cerebral arterial gas embolism. Symptomatic cerebral arterial gas embolism is a rare complication of endovascular intervention for acute ischaemic stroke. Although there are no previous descriptions of its successful treatment with hyperbaric oxygen therapy following mechanical thrombectomy, this is likely to become more common as mechanical thrombectomy is increasingly used worldwide to treat acute ischaemic stroke.

摘要

脑动脉气体栓塞是血管内介入治疗公认的并发症,估计发病率为0.08%。其诊断主要依靠临床症状,并由神经影像学检查辅助。治疗依赖于缓解机械性梗阻并逆转导致组织缺血的促炎过程。高压氧治疗是一种有效的治疗方法,具有多种机制来逆转脑动脉气体栓塞所涉及的病理过程。有症状的脑动脉气体栓塞是急性缺血性脑卒中血管内介入治疗的罕见并发症。尽管此前尚无机械取栓术后高压氧治疗成功案例的描述,但随着机械取栓在全球范围内越来越多地用于治疗急性缺血性脑卒中,这种情况可能会变得更加常见。

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