颅内血管内治疗大脑前动脉闭塞。
Endovascular treatment for anterior cerebral artery occlusions.
机构信息
Department of Neurology, Center of Stroke, Selcuk University Medical Faculty, Konya, Turkey.
Department of Neurology, Stroke Center, Ataturk University, Erzurum, Turkey.
出版信息
Interv Neuroradiol. 2024 Aug;30(4):571-578. doi: 10.1177/15910199231162669. Epub 2023 Mar 14.
BACKGROUND
We sought to examine the feasibility, safety and preliminary efficacy of anterior cerebral artery (ACA) occlusions in patients undergoing endovascular treatment.
METHODS
Four hundred five consecutive patients with large-vessel occlusion treated with endovascular treatment were analysed to identify all patients with acute ACA occlusion who underwent endovascular treatment.
RESULTS
Twenty had ACA occlusion (primary ACA occlusion: 9, rescue ACA occlusion: 11), 395 patients had other occlusions (internal carotid artery and MCA). The median [IQR] mRS score in the third month was significantly higher in the ACA-rescue occlusion group versus the ACA-primary occlusion group. The rate of haematoma in patients with ACA-occlusions was significantly higher compared with the ACA-primary occlusion group. Moreover, the three-month mortality rate was higher in patients with ACA-rescue than the patients with ACA-primary.
CONCLUSIONS
Although endovascular treatment can be considered in patients with primary ACA occlusions, our data suggest that future clinical trials are needed to determine the efficacy of endovascular treatment for ACA occlusions. Unfavourable outcomes in our study were considered to occur in the rescue ACA occlusions.
背景
我们旨在探讨血管内治疗中大脑前动脉（ACA）闭塞患者的可行性、安全性和初步疗效。
方法
对 405 例接受血管内治疗的大血管闭塞患者进行分析，以确定所有接受血管内治疗的急性 ACA 闭塞患者。
结果
20 例患者存在 ACA 闭塞（原发性 ACA 闭塞：9 例，挽救性 ACA 闭塞：11 例），395 例患者存在其他闭塞（颈内动脉和 MCA）。在第三个月，ACA 挽救性闭塞组的 mRS 评分中位数（IQR）明显高于 ACA 原发性闭塞组。与 ACA 原发性闭塞组相比，ACA 闭塞患者的血肿发生率明显更高。此外，在 ACA 挽救性闭塞患者中，三个月死亡率高于 ACA 原发性闭塞患者。
结论
尽管可以考虑对原发性 ACA 闭塞患者进行血管内治疗，但我们的数据表明，需要进行未来的临床试验来确定血管内治疗对 ACA 闭塞的疗效。在我们的研究中，不良预后被认为发生在挽救性 ACA 闭塞患者中。
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