局部动脉内溶栓结合经皮腔内血管成形术治疗急性大脑中动脉闭塞

Combined local intravascular thombolysis and percutaneous transluminal angioplasty for acute middle cerebral artery occlusion

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闭塞中的应用。方法：７例急性大脑中动脉闭塞用局部动脉内灌注ｔ－ＰＡ溶栓，６例Ｍ１段同时存在狭窄，用ＰＴＡ成功消除；所有病例均在发病６小时内开始治疗。结果：７例均获得闭塞动脉完全再通，６例Ｍ１段狭窄用ＰＴＡ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闭塞的有效方法。

Objective: To evaluate the application of local intravascular thrombolysis and PTA for acute middle cerebral artery occlusion. Method: 7 cases with acute middle cerebral arteries occlusion were treated by local intravascular infusion of tPA, PTA was used to eliminate the stenosis existed simultaneously in 6 cases. All cases were treated in 6 hours after the onset of symptom. Result: MCA reopened in 7 cases. M1 segment stenosis disappeared after PTA in 6 cases and 5 cases recovered from their hemi paresis. Conclusion: Local intravascular thrombolysis combined PTA may be an alternative therapy for acute middle cerebral artery occlusion.