高龄患者急性基底动脉闭塞Solitaire机械取栓治疗及文献回顾

Mechanical Thrombectomy with Solitaire Stent in the Treatment of Acute Basilar Artery Occlusion in the Senile and Literature Review

中文关键词: 基底动脉  动脉闭塞性疾病  高龄  机械取栓

英文关键词: basilar artery  arterial occlusive disease  senile  mechanical thrombectomy

中文摘要:

      目的 探讨高龄患者急性基底动脉闭塞机械取栓的疗效和安全性.方法 回顾性分析5例高龄急性基底动脉闭塞患者Solitaire机械取栓治疗的临床及影像学数据,同时进行急性基底动脉闭塞的相关文献回顾.结果 5例患者年龄80 ～ 84岁,平均(81.4±1.7)岁,其中男性4例、女性1例.基底动脉中段闭塞3例、远端闭塞2例.患者术前美国国立卫生研究院卒中量表评分(29.60 ±5.94)分.1例患者取栓前进行了重组组织型纤溶酶原激活剂静脉溶栓桥接血管内再通治疗.所有患者取栓支架平均通过次数(2.00±1.22)次,发病至血管再通时间(471.40± 137.02) min,血管成功再通率达100％,4例患者术后复查头颅CT未见出血.患者90d良好功能预后为40％,死亡率为40％.结论 高龄患者急性基底动脉闭塞使用Solitaire进行机械取栓治疗是可行的.

英文摘要:

      Objective To investigate the efficacy and safety of mechanical thrombectomy with Solitaire stent in the treatment of acute basilar artery occlusion in the senile.Methods A retrospective analysis was made to the clinical and imaging data of 5 senile cases with acute basilar artery occlusion treated by mechanical thrombectomy with Solitaire stent and related literatures were reviewed.Results The 5 cases were at the age from 80 to 84 with the average of (81.4±1.7),4 male and 1 female;3 cases had occlusions at the middle part of basilar artery while 2 at distal;the average NIHSS of the 5 cases before operation was (29.60±5.94);1 cases received intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA) for recanalization before thrombectomy;the average times of stent passing through were (2.00± 1.22) and the mean time from symptom onset to vessel recanalization was (471.40 ± 137.02) min with the successful rate of 100 ％;the postoperative cranial CT scanning found no hemorrhage;the rate of good outcome at the time point of the 90th day in follow-up was 40％ while the mortality was 40％.Conclusions Mechanical thrombectomy with Solitaire stent is feasible in the treatment of acute basilar artery occlusion in the senile.