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[基底动脉闭塞/严重狭窄患者的侧支循环途径:单中心病例系列]

[Collateral circulation pathway in patients with basilar artery occlusion/severe stenosis: a single-center case series].

作者信息

Bian Y, Wang K Y, Miao Y, Zhong X L, Jia S S, Qiu F

机构信息

Department of Neurology, the Sixth Medical Center of PLA General Hospital, Beijing 100048, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2021 Aug 1;60(8):734-738. doi: 10.3760/cma.j.cn112138-20210217-00131.

Abstract

To investigate the collateral circulation compensation model in patients with favorable prognosis of basilar artery occlusion/severe stenosis treated with drugs or endovascular therapy. Clinical data of patients with basilar artery occlusion/severe stenosis and good clinical outcome were retrospectively collected in the Department of Neurology, Sixth Medical Center of PLA General Hospital from January 2019 to January 2020. They were divided into intensive drug therapy group and combined endovascular therapy group. The number and ways of collateral compensation pathway described by digital substraction angiography (DSA) were analyzed, and the characteristics of the collateral compensation model were summarized. SPSS22.0 software was used for statistical analysis, and the constituent ratio (%) was used for statistical description of the enumeration data. A total of 32 eligible patients were included, including 27 males and 5 females, with an average age 45-76 (59±10) years. The compensation model included posterior communicating artery-posterior cerebral artery (13 cases, 40.6%), posterior communicating artery-posterior cerebral artery-basilar artery (10 cases, 31.2%), cerebellar artery-anastomotic branches of superior cerebellar artery (8 cases, 25.0%), anterior choroid artery-anastomotic branches of posterior choroid artery (2 cases, 6.2%), collateral circulation not established (11 cases, 34.4%).In drug treatment group, collateral compensation was found in the majority (14/15), with mainly posterior communicating artery (10/14).Most patients in combined treatment group did not develop collateral compensation (10/17), anastomotic branches of PICA-SCA were the main routes (6/7). In patients with basilar artery occlusion/severe stenosis, favorable clinical outcome can be achieved in both groups of patients treated with intensive drug therapy or endovascular therapy.

摘要

探讨药物或血管内治疗的基底动脉闭塞/重度狭窄预后良好患者的侧支循环代偿模式。回顾性收集2019年1月至2020年1月解放军总医院第六医学中心神经内科收治的基底动脉闭塞/重度狭窄且临床结局良好患者的临床资料。将其分为强化药物治疗组和血管内联合治疗组。分析数字减影血管造影(DSA)所描述的侧支代偿途径的数量和方式,总结侧支代偿模式的特点。采用SPSS22.0软件进行统计分析,构成比(%)用于计数资料的统计描述。共纳入32例符合条件的患者,其中男性27例,女性5例,平均年龄45 - 76(59±10)岁。代偿模式包括后交通动脉 - 大脑后动脉(13例,40.6%)、后交通动脉 - 大脑后动脉 - 基底动脉(10例,31.2%)、小脑动脉 - 小脑上动脉吻合支(8例,25.0%)、脉络膜前动脉 - 脉络膜后动脉吻合支(2例,6.2%)、未建立侧支循环(11例,34.4%)。在药物治疗组中,多数患者(14/15)发现有侧支代偿,主要为后交通动脉(10/14)。联合治疗组多数患者未形成侧支代偿(10/17),小脑后下动脉 - 小脑上动脉吻合支为主要途径(6/7)。在基底动脉闭塞/重度狭窄患者中,强化药物治疗或血管内治疗的两组患者均可取得良好的临床结局。

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