机械取栓治疗急性基底动脉闭塞的疗效

Clinical efficacy of mechanical thrombectomy for patients with acute basilar artery occlusion

目的探讨机械取栓术治疗急性基底动脉闭塞的临床效果。方法回顾性分析2021年1月至2022年10月机械取栓治疗的16例急性基底动脉闭塞的临床资料。根据TICI评分评估取栓后动脉再通情况,采用美国国立卫生研究院卒中量表(NIHSS)评分评估神经功能,术后90 d采用改良Rankin量表(mRS)评分评估预后状况。结果16例均使用TrevoProVue取栓支架进行取栓,术后TICI分级3级14例,2b级2例,血管再通率为100%。出院时NIHSS评分[(26.06±11.48)分]较入院时[(31.89±7.08)分]明显降低(P<0.05)。术后90 d,mRS评分0~2分4例(25%),3~5分12例,其中5例术后7 d内死亡。结论急性基底动脉闭塞的病死率及致残率很高,机械取栓术是一种安全、有效的治疗方法,但预后的影响因素较多,病人的预后仍有待改善。

Objective To investigate the clinical efficacy of mechanical thrombectomy for patients with acute basilar artery occlusion.Methods The clinical data of 16 patients with acute basilar artery occlusion treated by mechanical thrombectomy from January 2021 to October 2022 were retrospectively analyzed.The arterial recanalization after thrombectomy was evaluated according to the TICI grade,the neurological function was evaluated using the National Institutes of Health Stroke Scale(NIHSS)score,and the prognosis was evaluated using the modified Rankin Scale(mRS)score 90 days after surgery.Results All 16 patients were treated with TrevoProVue thrombectomy stent.TICI grade 3 was achieved in 14 patients and grade 2b in 2,and the vascular recanalization rate was 100%.The NIHSS score at discharge[(26.06±11.48)points]was significantly lower than that[(31.89±7.08)points]at admission(P<0.05).A mRS score of 0~2 was achieved in 4 patients(25%)and a mRS score of 3~5 in 12 patients,of whom 5 died within 7 days after surgery.Conclusions The mortality and disability rates of acute basilar artery occlusion are very high.Mechanical thrombectomy is a safe and effective treatment method,but there are many prognostic factors,and the prognosis of patients still needs to be improved.