支架取栓术治疗急性大脑中动脉闭塞效果分析

Analysis of the effect of stent thrombectomy for the treatment of acute middle cerebral artery occlusion

目的分析支架取栓术治疗急性大脑中动脉闭塞的临床效果。方法 28例急性大脑中动脉闭塞患者,利用Solitaire FR型支架取栓术治疗,观察其效果。结果 28例患者均为大脑中动脉M1段闭塞(右侧12例,左侧16例), 26例血管再通(92.9%),再通后发生再灌注出血1例(3.8%),家属拒绝手术,放弃治疗, 1例发生大面积脑梗死行去骨瓣减压术(3.8%)。2例血管未通(7.1%),出现大面积脑梗死。术后90 d进行随访,因再灌注出血、脑肿胀或其他并发症共死亡4例,患者预后良好14例(58.3%)。结论支架取栓术治疗急性大脑中动脉闭塞可获得良好血管再通,提高临床预后。

Objective To analyze the clinical effect of stent thrombectomy for for the treatment of acute middle cerebral artery occlusion. Methods A total of 28 patients with acute middle cerebral artery occlusion were treated with Solitaire FR stent thrombectomy and the effect was observed. Results All the 28 patients were middle cerebral artery M1 occlusion(12 right cases, 16 left cases), 26 cases(92.9%) were revascularized and1 case(3.8%) suffered from reperfusion hemorrhage after revascularization. The family refused operation and gave up treatment, and 1 case(3.8%) suffered from massive cerebral infarction underwent decompression with decompressive craniectomy. 2 vascular failure cases(7.1%) suffered from massive cerebral infarction. After 90 d of follow-up, 4 patients died of reperfusion hemorrhage, brain swelling or other complications, and 14 patients(58.3%)had good prognosis. Conclusion Stent thrombectomy for acute middle cerebral artery occlusion can achieve good vascular recanalization and improve clinical prognosis.