[1]姜世豪,夏源,艾孜买提江·吐尔逊,等.Hasan分型A型慢性颈内动脉闭塞的外科治疗[J].中国临床神经外科杂志,2024,29(04):193-197.[doi:10.13798/j.issn.1009-153X.2024.04.001]
　JIANG Shi-hao,XIA Yuan,AIZIMAITIJIANG Tuerxun,et al.Clinical efficacy of surgical treatment for Hasan type A chronic internal carotid artery occlusion[J].,2024,29(04):193-197.[doi:10.13798/j.issn.1009-153X.2024.04.001]
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Hasan分型A型慢性颈内动脉闭塞的外科治疗()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年04期
页码:
193-197
栏目:
论著
出版日期:
2024-04-30

文章信息/Info

Title:
Clinical efficacy of surgical treatment for Hasan type A chronic internal carotid artery occlusion
文章编号:
1009-153X（2024）04-0193-05
作者:
姜世豪; 夏源; 艾孜买提江·吐尔逊; 麦麦提亚生·麦麦提吐尔逊; 王凯; 阿西木江·阿西尔; 苏日青; 卡合尔曼·卡德尔; 王增亮; 买买提力·艾沙; 成晓江; 尼扎米丁江·热夏提
830054乌鲁木齐，新疆医科大学第一附属医院神经外科中心（姜世豪、艾孜买提江·吐尔逊、麦麦提亚生·麦麦提吐尔逊、王凯、阿西木江·阿西尔、苏日青、卡合尔曼·卡德尔、王增亮、买买提力·艾沙、成晓江、尼扎米丁江·热夏提）；830011乌鲁木齐新疆医科大学护理学院（夏源）
Author(s):
JIANG Shi-hao1;  XIA Yuan2;  AIZIMAITIJIANG Tuerxun1;  MAIMAITIYASHENG Maimaitituerxun1;  WANG Kai1;  AXIMUJIANG Axier1;  SU Ri-qing1;  KAHEREMAN Kadeer1;  WANG Zeng-liang1;  MAIMAITILI Aisha1;  CHENG Xiao-jiang1;  NIZAMIDINGJIANG Rexiati1
1. Department of Neurosurgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi 830054, China; 2. School of Nursing, Xinjiang Medical University, Urumqi 830011, China
关键词:
慢性颈内动脉闭塞; Hasan分型A型; 血管内治疗; 复合手术; 疗效
Keywords:
Chronic internal carotid artery occlusion;  Endovascular treatment;  Hybird operation;  Outcomes
分类号:
R 743; R 651.1+2
DOI:
10.13798/j.issn.1009-153X.2024.04.001
文献标志码:
A
摘要:
目的 探讨Hasan分型A型慢性颈内动脉闭塞（CICAO）的外科治疗方法及临床疗效。方法 回顾性分析2019年1月至2022年12月收治的32例Hasan分型A型CICAO的临床资料。术后根据AOL分级评估血管再通情况，其中≥2级为再通成功；术后依据北美NASCRT法评估术后再狭窄（狭窄率≥50％）。术后随访6个月，采用改良Rankin量表（mRS）评分评估预后。结果 16例采用血管内治疗，16例采用复合手术治疗；术后血管再通成功22例，未成功10例；治疗成功率为68.7%，其中血管内治疗的成功率为62.5%（10/16），复合手术治疗的成功率为75.0%（12/16）。7例（血管内治疗4例，复合手术治疗3例）术后发生手术并发症，包括高灌注综合征2例、颈内动脉海绵窦2例、血管夹层2例、支架内血栓1例。3例术后发生再狭窄，其中1例有临床症状，接受颞浅动脉-大脑中动脉分流术。术后6个月，mRS评分0~2分27例，3~5分5例。结论 Hasan分型A型CICAO病人行血管内治疗及复合手术治疗是安全的、有效的。与血管内治疗相比，复合手术治疗的技术成功率更高、手术并发症发生率更低。
Abstract:
Objective To investigate the surgical treatment and outcomes of Hasan type A chronic internal carotid artery occlusion (CICAO). Methods The clinical data of 32 patients with Hasan type A CICAO admitted from January 2019 to December 2022 were retrospectively analyzed. After surgery, the Arterial Occlusive Lesion (AOL) scale was used to measure the degree of recanalization, with grade 2~3 indicating successful reperfusion. The postoperative restenosis (stenosis rate ≥50%) was evaluated according to the North American NASCRT method. The patients were followed up for 6 months, and the prognosis was evaluated using the modified Rankin scale (mRS) score. Results Sixteen patients underwent endovascular treatment, and 16 underwent hybrid surgery; successful reperfusion was achieved in 22 patients, while 10 patients failed; the treatment success rate was 68.7%, with a success rate of 62.5% (10/16) for endovascular treatment and 75.0% (12/16) for hybrid surgery. Seven patients (4 endovascular treatment, 3 hybrid surgery) had postoperative complications, including hyperperfusion syndrome in 2 patients, cavernous sinus in 2 patients, dissection in 2 patients, and stent thrombosis in 1 patient. Three patients had restenosis, including 1 with clinical symptoms who underwent Superficial temporal artery-middle cerebral artery bypass. At 6 months, a mRS score of 0~2 was achieved in 27 patients and a mRS score of 3~5 in 5. Conclusions Endovascular treatment and hybrid surgery for patients with Hasan type A CICAO are safe and effective. Compared with endovascular treatment, hybrid surgery has a higher technical success rate and a lower incidence of surgical complications.

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备注/Memo

备注/Memo:
（2023-05-30收稿，2024-03-29修回） 基金项目：十三五国家重点研发计划（2016YFC1300800） 通信作者：尼扎米丁江·热夏提，Email：niza911@163.com
更新日期/Last Update: 2024-04-30