Hasan分型A型慢性颈内动脉闭塞的外科治疗
Clinical efficacy of surgical treatment for Hasan type A chronic internal carotid artery occlusion
姜世豪 1夏源 2艾孜买提江·吐尔逊 1麦麦提亚生·麦麦提吐尔逊 1王凯 1阿西木江·阿西尔 1苏日青 1卡合尔曼·卡德尔 1王增亮 1买买提力·艾沙 1成晓江 1尼扎米丁江·热夏提1
作者信息
- 1. 830054 乌鲁木齐,新疆医科大学第一附属医院神经外科中心
- 2. 830011 乌鲁木齐新疆医科大学护理学院
- 折叠
摘要
目的 探讨Hasan分型A型慢性颈内动脉闭塞(CICAO)的外科治疗方法及临床疗效.方法 回顾性分析2019年1月至2022年12月收治的32例Hasan分型A型CICAO的临床资料.术后根据AOL分级评估血管再通情况,其中≥2级为再通成功;术后依据北美NASCRT法评估术后再狭窄(狭窄率≥50%).术后随访6个月,采用改良Rankin量表(mRS)评分评估预后.结果 16例采用血管内治疗,16例采用复合手术治疗;术后血管再通成功22例,未成功10例;治疗成功率为68.7%,其中血管内治疗的成功率为62.5%(10/16),复合手术治疗的成功率为75.0%(12/16).7例(血管内治疗4例,复合手术治疗3例)术后发生手术并发症,包括高灌注综合征2例、颈内动脉海绵窦2例、血管夹层2例、支架内血栓1例.3例术后发生再狭窄,其中1例有临床症状,接受颞浅动脉-大脑中动脉分流术.术后6个月,mRS评分0～2分27例,3～5分5例.结论 Hasan分型A型CICAO病人行血管内治疗及复合手术治疗是安全的、有效的.与血管内治疗相比,复合手术治疗的技术成功率更高、手术并发症发生率更低.
Abstract
Objective To investigate the surgical treatment and outcomes of Hasan type A chronic internal carotid artery occlusion(CICAO).Methods The clinical data of 32 patients with Hasan type A CICAO admitted from January 2019 to December 2022 were retrospectively analyzed.After surgery,the Arterial Occlusive Lesion(AOL)scale was used to measure the degree of recanalization,with grade 2～3 indicating successful reperfusion.The postoperative restenosis(stenosis rate≥50%)was evaluated according to the North American NASCRT method.The patients were followed up for 6 months,and the prognosis was evaluated using the modified Rankin scale(mRS)score.Results Sixteen patients underwent endovascular treatment,and 16 underwent hybrid surgery;successful reperfusion was achieved in 22 patients,while 10 patients failed;the treatment success rate was 68.7%,with a success rate of 62.5%(10/16)for endovascular treatment and 75.0%(12/16)for hybrid surgery.Seven patients(4 endovascular treatment,3 hybrid surgery)had postoperative complications,including hyperperfusion syndrome in 2 patients,cavernous sinus in 2 patients,dissection in 2 patients,and stent thrombosis in 1 patient.Three patients had restenosis,including 1 with clinical symptoms who underwent Superficial temporal artery-middle cerebral artery bypass.At 6 months,a mRS score of 0～2 was achieved in 27 patients and a mRS score of 3～5 in 5.Conclusions Endovascular treatment and hybrid surgery for patients with Hasan type A CICAO are safe and effective.Compared with endovascular treatment,hybrid surgery has a higher technical success rate and a lower incidence of surgical complications.
关键词
慢性颈内动脉闭塞/Hasan分型A型/血管内治疗/复合手术/疗效Key words
Chronic internal carotid artery occlusion/Endovascular treatment/Hybird operation/Outcomes引用本文复制引用
基金项目
十三五国家重点研发计划(2016YFC1300800)
出版年
2024
NETL
NSTL
万方数据