目的 研究远端取栓支架保护下逆向开通的手术策略对前循环串联病变的疗效和安全性。方法 选取2018年1月至2023年12月成都西区医院接受介入开通手术的42例前循环串联病变急性缺血性卒中患者作为研究对象。根据手术策略分为观察组(n=23，采用远端支架保护)和对照组(n=19，采用保护伞保护)。比较两组间术中血栓逃逸率、术后24 h症状性颅内出血(SICH)发生率、成功开通率、总手术时间、术后90 d良好预后率及死亡率。结果 两组患者均全部成功开通，开通率100％。两组患者90 d良好预后率及致死率、术后24 h SICH发生率、总手术时间等比较差异无统计学意义(P>0。05)。观察组血栓远端逃逸率(4。3％)低于观察组(26。3％)，差异有统计学意义(P=0。043)。结论 在前循环串联病变开通术中，采用远端支架保护下逆向开通手术策略具有更低的血栓逃逸率，疗效和安全性方面与传统颈动脉保护伞下逆向开通相当。
Study on clinical effect of reversely opening anterior circulation tandem lesions under protection of distal stents
Objective To investigate the safety and efficacy of the surgical strategy of reversely opening under the protection of distal thrombectomy stent on anterior circulation tandem lesions.Methods A total of 42 patients with acute ischemic stroke with anterior circulation tandem lesions receiving opening surgery from January 2018 to December 2023 were selected as the study subjects.According to the surgical strategy,the pa-tients were divided into the observation group (n=23,adopting the distant stent protection) and the control group (n=19,adopting the protective umbrella protection).The intraoperative thrombus escape rate,inci-dence rate of 24 h symptomatic intracranial hemorrhage (SICH),successful opening rate,total operation time,good prognosis rate and mortality rate on postoperative 90 d were compared between the two groups. Results All patients in the both groups were successfully opened,and the opening rate was 100％.There were no statistically significant differences in the 90 d good prognosis rate and mortality rate,SICH incidence rate at postoperative 24 h and total operation duration between the both groups (P>0.05).The thrombus distal end escape rate in the observation group was lower than that in the control group with statistically significant difference (4.3％ vs. 26.3％,P=0.043).Conclusion In the opening operation of anterior circulation tandem lesions,adopting the reverse opening surgical strategy under the distal stents protection has a lower thrombus escape rate,which is comparable to that of reverse opening under the traditional carotid artery protective um-brella in the aspects of effect and safety.
anterior circulation tandem lesionsreverse openingsafetyefficacydistal stent protection
万方数据
维普
