Solitaire支架联合Navien颅内支撑导管治疗急性缺血性脑卒中疗效分析-现代医学

Solitaire支架联合Navien颅内支撑导管治疗急性缺血性脑卒中疗效分析

作者：李明超¹ 郭永涛¹ 蒋苏莉¹ 王焱峰¹ 夏磊¹ 梁晨² 高社荣² 孙洪刚²

单位：1. 淮安市第一人民医院神经内科, 江苏淮安 223300;
2. 兵团第七师医院神经内科, 新疆奎屯 833200

分类号：R743.3

出版年·卷·期（页码）：2018·37·第九期（1041-1044）

摘要：

目的：探讨Solitaire AB型支架联合Navien颅内支撑导管进行颅内大动脉急性闭塞机械血管再通的效果和安全性。方法：选择脑血管造影证实存在责任大血管闭塞的急性缺血性卒中患者30例，使用Solitaire AB型支架联合Navien颅内支撑导管进行大动脉急性闭塞的机械血管再通。分析即时血管再通情况，评估术后出血情况，比较患者手术前和手术后美国国立卫生研究院卒中量表（National Institutes of Health stroke scale，NIHSS）评分及术后3个月改良Rankins量表（modify Rankins scale，mRS）评分情况。结果：术后即刻及术后2周复查脑血管造影显示再通率分别为83.3%（25/30）和73.3%（22/30）。治疗前NIHSS评分为5~21分，平均（15±3）分，术后2周NIHSS评分3~20分，平均（10±4）分，与术前比差异有统计学意义（P<0.05）。3个月随访良好预后率（mRS<2分）为40%（12/30），病死率为16.7%（5/30）。结论：使用Solitaire AB型支架取栓联合Navien导管抽吸进行颅内大动脉急性闭塞的机械血管再通技术可有效提高血管再通率和减少远端栓塞事件。

Objective: To evaluate the efficacy and safety of Solitaire AB stent combined with Navien intracranial catheter in the treatment of acute artery occlusion. Methods: 30 patients with acute ischemic stroke with large artery occlusion confirmed by cerebral angiography underwent mechanical recanalization of acute large artery occlusion by using Solitaire AB stent combined with Navien intracranial catheter were collected into our study. The immediate vascular recanalization, postoperative hemorrhage, the National Institutes of Health stroke scale(NIHSS) scores before and after operation and modify Rankins scale(mRS) scores 3 months after operation were recorded and analyzed. Results: The immediate recanalization rate and the recanalization rate of 2 weeks after operation were 83.3% (25/30) and 73.3% (22/30), respectively. Before operation, the NIHSS score was 5-21 points, with an average of (15±3) points, 2 weeks after operation, the NIHSS score was 3-20 points, with an average of (10±4) points. Compared with before operation, the NIHSS score after operation was significantly decreased (P<0.05).The good prognosis3 months after operation (mRS<2) was 40%(12/30) and the mortality rate was 16.7%(5/30). Conclusion: The Solitaire AB stent combined with Navien intracranial catheter can be used in the treatment of acute large intracranial artery occlusion for improving the recanalization rate and reducing the distal embolic events.

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