急性大脑中动脉栓塞的局部动脉内溶栓治疗(附7例报告)

Local intraarterial thrombolysis for acute middle cerebral artery occlusion (7 cases report)

目的:评价局部动脉内溶栓和经皮腔内血管成形术(PTA)结合在治疗急性大脑中动脉栓塞中的应用。方法:7例急性大脑中动脉栓塞用局部动脉内灌注组织纤溶酶原激活物(t-PA)溶栓,6例M_1段同时存在狭窄,用PTA成功消除;所有病例均在发病6h内开始治疗。结果:7例栓塞动脉均获得完全再通,6例M_1段狭窄用FTA消除,5例偏瘫完全恢复,1例有脑出血并发症。结论:局部动脉内溶栓和PTA结合可能是治疗急性大脑中动脉栓塞的有效方法。

To evaluate the local intraarterial thrombolysis and combined with percutaneous transluminal angioplasty ( PTA ) for the treatment of acute thrombosis of middle cerebral artery (MCA). Method: The tissue plasminogen activator (t-PA) was infused into local artery for the treatment of acute thrombosis of MCA, stenosis of M_1 segment were found among 6 cases simultaneously. The stenosis was eliminated after PTA. The above mentioned treatment were performed within 6 hours after onset of symptoms in all patients. Result: Complete recanahzation was achieved in 7 occluded arteries. Stenosis of M] segment disappeared in 6 cases after PTA. Hemiplegia recovered completely in 5 cases. The complication of cerebral hemorrhage was found in 1 patient. Conclusion: Combination with local intraartenal thrombolysis and PTA may be an effective method for the treatment of acute middle cerebral arterv occlusion.