Ito Yuhei, Kojima Takao, Kobayashi Toru, Sato Naoki, Konno Yutaka, Oda Keiko, Fujii Masazumi
Department of Neurosurgery, Fukushima Medical University, Fukushima, Fukushima, Japan.
Department of Neurosurgery, Hoshi General Hospital, Koriyama, Fukushima, Japan.
J Neuroendovasc Ther. 2023;17(6):114-119. doi: 10.5797/jnet.oa.2023-0005. Epub 2023 May 10.
Most large-vessel occlusions (LVOs) amenable to acute recanalization occur in the internal carotid or middle cerebral artery. However, few LVOs with a multivessel disease can be difficult to treat. This study aimed to determine the outcomes of mechanical thrombectomy in patients with both anterior and middle cerebral artery occlusions.
We retrospectively collected data for patients who had undergone mechanical thrombectomy since January 2016 at Fukushima Medical University and its affiliated institutions (10 institutions). Patients with occluded vessels in the anterior and middle cerebral arteries were selected, and patient background, treatment course, and outcomes were reviewed.
A total of 341 mechanical thrombectomies were performed during the study period. Seven patients had occlusions involving both anterior and middle cerebral arteries. In these seven patients, the median time from onset to imaging, imaging to puncture, and puncture to recanalization was 106, 60, and 74 min, respectively. Only one patient (14%) had a modified Rankin Scale of 0-2 at 90 days.
Comorbid anterior cerebral artery occlusion may worsen the outcome of patients with middle cerebral artery occlusion.
大多数适合急性再通的大血管闭塞（LVO）发生在颈内动脉或大脑中动脉。然而，少数合并多支血管病变的LVO可能难以治疗。本研究旨在确定大脑前动脉和大脑中动脉均发生闭塞的患者进行机械取栓的疗效。
我们回顾性收集了自2016年1月起在福岛医科大学及其附属医院（10家机构）接受机械取栓治疗的患者的数据。选取大脑前动脉和大脑中动脉血管闭塞的患者，对患者的背景、治疗过程及疗效进行回顾。
在研究期间共进行了341例机械取栓手术。7例患者大脑前动脉和大脑中动脉均发生闭塞。在这7例患者中，从发病到影像学检查、影像学检查到穿刺、穿刺到再通的中位时间分别为106分钟、60分钟和74分钟。90天时仅有1例患者（14%）改良Rankin量表评分为0 - 2分。
合并大脑前动脉闭塞可能会使大脑中动脉闭塞患者的预后恶化。
