血管内治疗联合椎动脉内膜切除术治疗急性串联性椎基底动脉闭塞。
Endovascular treatment combined with vertebral artery endarterectomy for patients with acute tandem vertebrobasilar artery occlusion.
机构信息
Department of Radiology, Clinical Medical College of Shanghai Tenth People's Hospital of Nanjing Medical University, No. 301 Yanchang Road, Shanghai 200072, China.
Department of Vascular and Interventional Radiology, Nanjing First Hospital, Nanjing Medical University, No. 68 Changle Road, Nanjing 210006, Jiangsu, China.
出版信息
J Clin Neurosci. 2020 Sep;79:21-29. doi: 10.1016/j.jocn.2020.06.022. Epub 2020 Aug 5.
PURPOSE
To evaluate the safety and efficacy of endovascular treatment combined with vertebral artery endarterectomy in patients with acute tandem vertebrobasilar artery occlusion.
METHODS
From April 2017 to March 2019, three patients with acute basilar artery occlusion combined with ostial vertebral occlusion in our institution were enrolled in the study. They underwent endovascular treatment combined with vertebral artery endarterectomy. The clinical, technical and functional outcomes of the patients were retrospectively analysed.
RESULTS
All three patients in the study underwent complete recanalization. The modified Thrombolysis in Cerebral Infarction (mTICI) grade was 2b/3 in all patients. The modified Rankin Scale (mRS) score was 0-2 for the three patients at 3 months. Follow-up CT scans revealed no cerebral haemorrhage, and no patients died during follow-up. All patients achieved good clinical outcomes after the combined treatment.
CONCLUSION
Endovascular treatment combined with vertebral artery endarterectomy is a feasible method to treat patients with acute basilar artery occlusion combined with ostial vertebral occlusion, especially when the guidewire cannot pass through the ostium of the dominant vertebral artery occlusion.
目的
评估血管内治疗联合椎动脉内膜切除术治疗急性串联性椎基底动脉闭塞患者的安全性和疗效。
方法
自 2017 年 4 月至 2019 年 3 月，我院收治了 3 例急性基底动脉闭塞合并椎动脉开口闭塞的患者，采用血管内治疗联合椎动脉内膜切除术。回顾性分析患者的临床、技术和功能结局。
结果
研究中的 3 例患者均实现了完全再通，所有患者的改良脑梗死溶栓（mTICI）分级均为 2b/3。3 例患者在 3 个月时的改良 Rankin 量表（mRS）评分为 0-2。随访 CT 扫描未见脑内出血，随访期间无患者死亡。所有患者在联合治疗后均取得了良好的临床效果。
结论
血管内治疗联合椎动脉内膜切除术是治疗急性基底动脉闭塞合并椎动脉开口闭塞患者的一种可行方法，特别是在导丝无法通过优势椎动脉开口闭塞时。
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