经枕动脉肌支逆行开通闭塞椎动脉行基底动脉取栓一例

A case of basilar artery thrombectomy through retrograde opening of muscular branch of occipital artery

后循环大血管闭塞导致的急性缺血性卒中致残率和死亡风险高,血管内治疗可使中重度神经功能缺损患者显著受益。该文报道1例经枕动脉肌支逆行开通闭塞椎动脉行基底动脉取栓患者,以为常规入路难以完成血管再通患者的治疗提供新的思路。该患者为57岁男性,主要症状为意识不清3 h,病史结合影像学提示后循环大血管闭塞,急诊行机械取栓时优势椎动脉难以开通,遂经侧支循环途径逆行开通闭塞椎动脉行基底动脉取栓,术后即刻造影显示基底动脉完全再通。

Posterior circulation large vessel occlusion carries a high morbidity and mortality risk for acute ischemic stroke,and endovascular therapy significantly benefits patients with moderate to severe neurological deficits.In this paper,we reported a case of basilar artery thrombectomy through retrograde opening of the occluded vertebral artery via the muscular branch of the occipital artery in order to improve neurointerventionalists′new treatment perspective for patients who are difficult to complete recanalization by conventional approaches.The patient was a 57-year-old man with the main symptom of unconsciousness for 3 hours.The medical history combined with imaging revealed posterior circulation macrovascular occlusion.The dominant vertebral artery was difficult to open during mechanical thrombectomy.Therefore,basilar artery thrombectomy was performed by retrograde opening of the occluded vertebral artery through the collateral circulation route,and the blood flow was completely recanalized immediately after surgery.