大脑中动脉M2段闭塞血管再通研究进展

Advances in Recanalization of M2 Segment Occlusion in Middle Cerebral Artery

与颈内动脉和大脑中动脉M1段相比,大脑中动脉M2段更加纤细、迂曲,其急性闭塞后血管再通治疗包括静脉溶栓、动脉溶栓及机械取栓,但血管内治疗的安全性和有效性仍有争议。目前的研究显示,动脉溶栓和机械取栓的血管再通率高于单纯的静脉溶栓,但这3种治疗方法对90d预后的影响差异不大。另外,因研究相对较少,目前治疗方法对出血转化的影响尚无定论。

Compared with internal carotid artery(ICA)and middle cerebral artery(MCA)M1 segments,MCA M2 segments are more slender and tortuous.Recanalization methods for acute occlusion in MCA M2 segments include intravenous thrombolysis,arterial thrombolysis and mechanical thrombectomy.However,the safety and effectiveness of endovascular therapy still remained controversial.Current studies have shown that the recanalization rates of arterial thrombolysis and mechanical thrombectomy are higher than that of intravenous thrombolysis alone,while there is little difference in the prognosis at 90 days among the three treatment ways.In addition,due to relatively fewer studies,the impact of three treatment ways on hemorrhagic transformation remains inconclusive.