颈内动脉颅内段慢性闭塞血管内开通术的临床分析

Clinical analysis of endovascular recanalization for chronic intracranial segment of intracranial artery occlusion

目的探讨血管内再通术治疗症状性颈内动脉颅内段慢性闭塞的安全性和有效性。方法对颈内动脉颅内段慢性闭塞患者行血管内再通术治疗的患者9例,闭塞部位在颈内动脉C6-C7段,其中8例再通患者中全部使用了扩张球囊,其中2例使用球扩支架,6例使用自膨支架,收集全部患者的临床资料、影像学及随访资料进行回顾分析。结果从首次发病到介入再通时间21~43天,中位时间29天,9例患者中1例因导丝不能通过而结束手术,技术成功率89.1%(8/9),术后1例患者出现治疗侧可逆性视网膜中央动脉栓塞,无高灌注并发症,无死亡病例。随访3~12月,1例患者出现支架内轻度再狭窄(狭窄度30%),再狭窄率为11%,无卒中事件发生。结论血管内再通术治疗颈内动脉颅内段慢性闭塞安全可行,手术成功率高,经严格筛选标准下可以在临床上推广。

Objective To evaluate the safety and efficacy of endovascular recanalization in the treatment of chronic occlusion of symptomatic internal carotid artery.Methods Chronic intracranial internal carotid artery occlusion endovascular recanalization treatment of 9 cases of patients,in the internal carotid artery occlusion parts C6-C7 segment,8 cases of recanalization in patients with all used the balloon expansion,including 2 cases using ball expand stents,6 cases since used of stents,collection was involved all of the patient's clinical information,imaging,and follow-up data were analyzed retrospectively.Results The time from first onset to interventional recanalization was 21-43 days,median 29 days.One of the 9 patients ended the operation because the guide wire failed.The technical success rate was 89.1%(8/9).After surgery,one patient had a reversible central retinal arterial embolization on the treatment side,and there was no high perfusion complication and no death.During 3-12 months of follow-up,one patient developed mild restenosis within the stent(stenosis 30%),and the restenosis rate was 11%,no stroke occurred.Conclusion Endovascular recanalization is safe and feasible in the treatment of chronic occlusion of the internal carotid artery in the intracranial segment,with a high surgical success rate,and can be promoted clinically under strict screening criteria.