非顺应性球囊在颈内动脉闭塞血管内再通中的应用

Application of non-compliant balloon in recanalization of internal carotid artery occlusion

目的观察非顺应性球囊在颈内动脉闭塞血管内治疗中的安全性和有效性。方法选择2015年1月~2020年5月台州市第一人民医院神经内科采用血管内治疗开通颈内动脉闭塞患者103例,术中用半顺应性球囊预扩张(半顺应性球囊组)50例和非顺应性球囊预扩张(非顺应性球囊组)53例,回顾性分析2组临床及影像学资料。结果非顺应性球囊组最狭窄处直径较半顺应性球囊组明显增宽[(1.89±0.16)mm vs(1.69±0.14)mm,P=0.000];远端滤网装置一次通过率均较半顺应性球囊组明显增高(98.1%vs 80.0%,P=0.003),2组动脉夹层比例比较,差异无统计学意义(P>0.05)。半顺应性球囊组与非顺应性球囊组新发脑梗死和血管再狭窄率比较,差异无统计学意义(20.0%vs 17.0%,P=0.801,24.0%vs 28.3%,P=0.660)。结论术中使用非顺应性球囊预扩张辅助颈内动脉闭塞血管内治疗安全有效,且增加球囊扩张后远端滤网装置一次通过率,球囊扩张后最狭窄处直径较半顺应性球囊更大。

Objective To study the safety and efficacy of non-compliant balloon in recanalization of internal carotid artery occlusion(ICAO).Methods One hundred and three ICAO patients admitted to our hospital from January 2015 to May 2020 for recanalization of their ICAO were divided into semi-compliant balloon group(n=50)and non-compliant balloon group(n=53).Their clinical and imaging data were retrospectively analyzed.Results The shortest balloon diameter at the narrowest segment was significantly longer and the first pass rate of distal filter net device was significantly higher in non-compliant balloon group than in semi-compliant balloon group(1.89±0.16 mm vs 1.69±0.14 mm,P=0.000;98.1%vs 80.0%,P=0.003).No significant difference was detected in carotid artery dissection between the two groups(P>0.05)and in incidence of new onset cerebral infarction and intraartery restenosis between the two groups(20.0%vs 17.0%,P=0.801,24.0%vs 28.3%,P=0.660).Conclusion It is safe and effective to use non-compliant balloon predilation to assist the treatment of internal carotid artery occlusion,and to increase the primary pass rate of the distal filter device after balloon dilation.The diameter of the narrowest part after balloon dilation is longer than that of semi-compliant balloon.