腔内治疗自发性颈动脉夹层合并缺血性脑卒中的分析
Analysis of the endovascular treatment of spontaneous carotid artery occlusion combined with ischemic stroke
周保宁 1化召辉 1单金涛 1杜世昌 1薛文豪 1夏磊 1罗云鹏 1柴一鸣 1李震1
作者信息
- 1. 郑州大学第一附属医院 腔内血管外科,河南 郑州 450052
- 折叠
摘要
目的 探讨腔内技术在治疗自发性颈动脉夹层合并缺血性脑卒中患者的应用和疗效.方法 回顾性分析 2018 年 6 月至 2023 年 6 月郑州大学第一附属医院利用腔内技术治疗的 35 例自发性颈动脉夹层合并缺血性脑卒中患者临床资料,统计患者住院及随访期间脑缺血和脑出血事件发生率、支架通畅率和死亡率等.结果 手术成功率 100%.围手术期发生远端栓塞 1 例,发生蛛网膜下腔出血 1 例,均经保守治疗后复良好;发生无症状性支架内闭塞 2 例;死亡 1 例,因脑出血继发脑水肿、脑疝死亡,死亡率为 2.86%.患者随访 6～60 个月,平均(27.62±14.80)个月,发生无症状性支架内狭窄 1 例,1例患者因远端残余夹层动脉瘤形成行二次手术.患者均无脑缺血及死亡事件发生.结论 腔内技术用于治疗自发性颈动脉夹层合并缺血性脑卒中患者成功率高,安全性较好,围手术期并发症发生率低.
Abstract
Objective To explore the application and efficacy of endovascular techniques in the treatment of spontaneous carotid artery dissections combined with ischemic stroke.Methods The clinical data of 35 patients with spontaneous carotid artery dissections combined with ischemic stroke treated with endovascular techniques from June 2018 to June 2023 by the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.The rates of cerebral ischemic and cerebral hemorrhage events,stent patency rate and mortality rate during the hospitalization and follow-up period were counted.Results The success rate of the procedure was 100%.One case occurred distal embolism and subarachnoid hemorrhage in the perioperative period,respectively,and both recovered well after conservative treatment.Two cases of asymptomatic in-stent occlusion occurred during the perioperative period.One case died due to cerebral hernia secondary to cerebral hemorrhage and cerebral edema,with a mortality rate of 2.86%.Patients were followed-up for 6-60 months,with a mean time of 27.62±14.80 months.One case occurred asymptomatic in-stent stenosis during the follow-up period,and one patient underwent a second operation for distal residual dissection aneurysm formation.No patient had ischemic events or deaths during the follow-up period.Conclusion Endovascular techniques for spontaneous carotid artery dissections combined with ischemic stroke have a high success rate,good safety and low rate of perioperative complications.
关键词
颈动脉/夹层/缺血性脑卒中/支架植入术/腔内手术Key words
Carotid artery/Dissection/Ischemic stroke/Stenting/Endovascular treatment引用本文复制引用
基金项目
国家自然科学基金面上项目(82370503)
出版年
2024
NETL
NSTL
维普
万方数据