Clinical effect of mechanical thrombectomy for acute cerebral infarction caused by relatively small vessel occlusion
10.3760/cma.j.issn.1008-6315.2018.06.007
- VernacularTitle:相对小血管闭塞致急性脑梗死机械取栓临床效果观察
- Author:
Qingfeng ZHU
1
;
Guofang WANG
;
Qi SUN
;
Hongmei GUO
;
Yu WANG
Author Information
1. 解放军264医院神经外科
- Keywords:
Small vessel Occlusion;
Solitiare stent;
Mechanical thrombectomy;
Stroke
- From:Clinical Medicine of China
2018;34(6):511-516
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety and effectiveness of mechanical thrombectomy with Solitaire stent in intracerebral relatively small artery occlusions,such as the anterior cerebral artery,the posterior cerebral artery, the middle cerebral artery M2-M3. Methods The clinical data of thirteen cases of acute cerebral infarction caused by occlusion of relatively small vessels ( anterior cerebral artery, posterior cerebral artery, middle cerebral artery M2-M3 ) caused by intravenous thrombolytic time window with relative small vascular occlusion in our hospital were reviewed and analyzed. The NIHSS score, occlusion of vascular recanalization,surgical complications,and clinical prognosis (3 months mRs) were analyzed before and after discharge,including 6 cases of M2-M3 occlusion in the middle cerebral artery,3 cases of anterior cerebral artery occlusion and 4 cases of posterior cerebral artery occlusion. Results In 13 cases, the time window of thrombectomy was 3. 5～7. 0 h,the time from onset to reflow was (4. 53±3. 21) h,and 13 cases of blood vessels were completely repassed,of which 11 cases were grade 3 TICI,and 2 cases of 2b grade in TICI classification. 2 cases of postoperative small lateral fissure and subarachnoid hemorrhage. The score of NIHSS was reduced from (19. 53±1. 62)points to (3. 15±0. 41)points at 2 weeks. The difference was statistically significant (t=1. 763, P<0. 01);the mRs scores of 90d were 0 points 7 cases(53. 85％),1 points 3 cases(23. 08％),2 points cases ( 23. 08％) ,death 0 case. Conclusion The patients with acute cerebral infarction caused by relatively small vascular occlusion, such as the anterior cerebral artery, the posterior cerebral artery and the middle cerebral artery ( M2-M3) are treated with stent embolectomy in the time window. The rate of vascular repassage is high and the complications are low, and the patient′s disability rate can be significantly reduced and the clinical prognosis is better.
