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颅内动脉粥样硬化所致大血管闭塞的当前认识:聚焦早期诊断

Current knowledge of large vascular occlusion due to intracranial atherosclerosis: focusing on early diagnosis.

作者信息

Li He, Liu Peng, Liu Pei, Hua Weilong, Yang Wenjin, Zhang Yongxin, Zhang Lei, Xing Pengfei, Li Zifu, Zhang Yongwei, Hong Bo, Yang Pengfei, Liu Jianmin

机构信息

Department of Neurosurgery, Changhai Hospital, Changhai Road Num. 168, Shanghai, 200433 China.

Stroke Center, Changhai Hospital, Changhai Road Num. 168, Shanghai, 200433 China.

出版信息

Chin Neurosurg J. 2020 Oct 1;6:32. doi: 10.1186/s41016-020-00213-1. eCollection 2020.

Abstract

Intracranial atherosclerosis (ICAS)-related large vascular occlusion (LVO) was an intractable subtype of acute ischemic stroke (AIS), which always needed rescue angioplasty and stenting and complicated the procedure of endovascular recanalization. Diagnosing ICAS-LVO accurately and early was helpful for both clinical treatment and trials. Digital subtraction angiography (DSA) was unable to provide an early and rapid diagnosis of ICAS-LVO based on current studies. A variety of pre-DSA methods had been used to distinguish ICAS-LVO with other subtypes of ischemic stroke, such as medical histories, clinical presentations, computed tomography or angiography (CT/CTA), and magnetic resonance imaging (MRI/MRA). This article briefly reviewed the status quo of the diagnosis and treatment of ICAS-LVO and summarized early diagnostic methods of ICAS-LVO from different aspects.

摘要

颅内动脉粥样硬化(ICAS)相关的大血管闭塞(LVO)是急性缺血性卒中(AIS)的一种难治性亚型,总是需要进行血管成形术和支架置入术进行抢救,并且使血管内再通手术变得复杂。早期准确诊断ICAS-LVO对临床治疗和试验均有帮助。根据目前的研究,数字减影血管造影(DSA)无法对ICAS-LVO进行早期快速诊断。多种DSA前的方法已被用于鉴别ICAS-LVO与其他缺血性卒中亚型,如病史、临床表现、计算机断层扫描或血管造影(CT/CTA)以及磁共振成像(MRI/MRA)。本文简要回顾了ICAS-LVO的诊断和治疗现状,并从不同方面总结了ICAS-LVO的早期诊断方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a465/7528346/cd6c62254e2c/41016_2020_213_Fig1_HTML.jpg

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