[1]冯　光　杨　铭　潘　力　冯　雷　韩冰莎　王瑞康　马廉亭.症状性椎-基底动脉闭塞非急性期介入开通治疗分析[J].中国临床神经外科杂志,2019,(11):641-644.[doi:10.13798/j.issn.1009-153X.2019.11.001]
　FENG Guang,YANG Ming,PAN Li,et al.Clinical analysis of non-acute intervention treatment of symptomatic intracranial vertebral basilar artery occlusion[J].,2019,(11):641-644.[doi:10.13798/j.issn.1009-153X.2019.11.001]
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症状性椎-基底动脉闭塞非急性期介入开通治疗分析 ()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2019年11期
页码:
641-644
栏目:
论著
出版日期:
2019-11-25

文章信息/Info

Title:
Clinical analysis of non-acute intervention treatment of symptomatic intracranial vertebral basilar artery occlusion
文章编号:
1009-153X（2019）11-0641-04
作者:
冯　光　杨　铭　潘　力　冯　雷　韩冰莎　王瑞康　马廉亭
430070 武汉，中国人民解放军中部战区总医院神经外科（冯　光、杨　铭、潘　力、冯　雷、马廉亭）；450000 郑州，河南省人民医院神经外科（韩冰莎、王瑞康）
Author(s):
FENG Guang1;  YANG Ming1;  PAN Li1;  FENG Lei1;  HAN Bing-sha2;  WANG Rui-kang2;  MA Liang-ting1.
1. Department of Neurosurgery, General Hospital, Central Theater, PLA, Wuhan 430070; 2. Department of Neurosurgery, Henan Provincial People`s Hospital, Zhengzhou 450000, China
关键词:
椎-基底动脉闭塞; 非急性期; 介入治疗; 临床预后
Keywords:
Intracranial vertebral basilar arteries;  Occlusion;  Non-acute phase;  Interventional therapy
分类号:
R 743; R 815.2
DOI:
10.13798/j.issn.1009-153X.2019.11.001
文献标志码:
A
摘要:
目的 探讨椎-基底动脉闭塞非急性期介入再通治疗的安全性及有效性，并比较椎动脉闭塞与基底动脉闭塞的预后。方法 回顾性分析2013年2月到2017年9月介入再通治疗的100例椎-基底动脉闭塞的临床资料，其中单纯椎动脉闭塞56例（椎动脉组），椎动脉合并基底动脉闭塞44例（基底动脉组）。结果 100例中，96例实现血管再通。围手术期发生并发症13例。术后30 d内死亡7例，术后5个月死亡1例，术后10个月死亡1例。术后6个月改良Rankin量表（mRS）评分[（2.24±1.16）分]、术后12个月mRS评分[（2.07±1.23）分]较术前[（3.98±0.89）分]均明显降低（P<0.05）。椎动脉组和基底动脉组再通率、围手术期并发症发生率、病情恶化率及出院时mRS评分均没有统计差异（P>0.05）。基底动脉组病死率（18.18%，8/44）明显高于椎动脉组（1.79%，1/56；P<0.05）。两组术后6个月mRS评分较术前均明显降低（P<0.05），而且，椎动脉组明显低于基底动脉组（P<0.05）。结论 症状性椎-基动脉闭塞非急性期介入再通治疗的再通率高，可改善长期预后；与单纯椎动脉闭塞相比，椎动脉合并基底动脉闭塞开通治疗效果较差。
Abstract:
Objective To evaluate the safety and efficacy of endovascular recanalization in the patients with non-acute vertebral basilar artery occlusion and to compare the prognosis between vertebral and basilar arteries occlusions. Methods One hundred patients, of whom, 56 suffered from the non-acute intracranial vertebral artery occlusion and 44 from the non-acute basilar artery occlusion, were treated by intervention technique from February, 2013 to September, 2017. The prognoses were assessed by Rankin scale (mRS) 12 months after the treatment and were compared between both the groups. Results Of 56 patients with vertebral artery occlusion, 55 received the successful recanalization of the occluded arteries and 1 not. Of 44 patients with basilar artery occlusion, 41 received the successful recanalization of the occluded arteries and 3 not. Of 13 patients with postoperative complications, 7 (12.50%, 7/56) preoperatively suffered from the vertebral artery occlusion and 6 (13.64%, 6/44) from the basilar artery occlusion. Of 9 patients who died after the operation, 1 (1.79%, 1/56) was in the vertebral artery occlusion group and 8 (18.18%, 8/44) in the basilar artery occlusion group. The scores of mRS were significantly better 12 months after the operation than those before the operation in both the groups (P<0.05). There was insignificant difference in the scores of mRS between both the groups 12 months after the operation (P>0.05). The mortality was significantly higher in the basilar artery occlusion group than that in the vertebral artery occlusion group (P<0.05). There were insignificantly differences in ths rates of vascular recanalization and occurrence of postoperative complication between the both the groups (P>0.05). Conclusions The intervention recanalization is practicable and safe in the patients with non-acute vertebral and basilar arteries occlusions, and its curative effects on the vertebral and basilar arteries occlusions is good.

参考文献/References:

[1] Ma N, Zhang Y, Shuai J, et al. Stenting for symptomatic intracranial arterial stenosis in China: 1-year outcome of a multicentre registry study [J]. Stroke Vasc Neurol, 2018, 3 (3): 176-184. [2] He Y, Wang Z, Li T, et al. Preliminary findings of recanali- zation and stenting for symptomatic vertebrobasilar artery occlusion lasting more than 24 h: a retrospective analysis of 21 cases [J]. Eur J Radiol, 2013, 82(9): 1481-1486. [3] Chen YH, Leong WS, Lin MS, et al. Predictors for successful endovascular intervention in chronic carotid artery total occlusion [J]. JACC Cardiovasc Interv, 2016, 9(17): 1825- 1832. [4] 中国医师协会介入医师分会神经介入专业委员会，中华 医学会放射学分会介入放射学组，中国卒中学会复合介 入神经外科分会，等. 慢性颈内动脉闭塞再通治疗中国 专家共识[J]. 中华介入放射学电子杂志，2019，7（1）：1-6. [5] Liu L, Zhao X, Mo D, et al. Stenting for symptomatic intra- cranial vertebrobasilar artery stenosis: 30-day results in a high-volume stroke center [J]. Clin Neurol Neurosurg, 2016, 143: 132-138. [6] Dashti SR, Park MS, Stiefel MF, et al. Endovascular recana- lization of the subacute to chronically occluded basilar artery: initial experience and technical considerations [J]. Neurosurgery, 2010, 66(4): 825-832. [7] Lin R, Aleu A, Jankowitz B, et al. Endovascular revascular- ization of chronic symptomatic vertebrobasilar occlusion [J]. J Neuroimaging, 2012, 22(1): 74-79. [8] Gross BA, Hurley MC, Bernstein R, et al. Endovascular recanalization for subacute symptomatic intracranial arterial occlusion: a report of two cases [J]. Clin Neurol Neurosurg, 2008, 110(10): 1058-1063. [9] Lee CW, Lin YH, Liu HM, et al. Predicting procedure successful rate and 1-year patency after endovascular recanalization for chronic carotid artery occlusion by CT angiography [J]. Int J Cardiol, 2016, 221: 772-776.

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备注/Memo

备注/Memo:
通讯作者：马廉亭，E-mail：mlt1937@163.com（2019-10-23收稿，2019-10-31修回）
更新日期/Last Update: 2019-11-20