中国脑血管病杂志2012，Vol.9Issue(4)：183-188,6.DOI:10.3969/j.issn.1672-5921.2012.04.004
动脉内溶栓联合血管成形术治疗发病六小时内椎-基底动脉系统缺血性卒中患者的疗效
Arterial thrombolysis in combination with angioplasty for treatment of vertebrohasilar ischemie stroke
李慧英 1蒋初明 1缪中荣 2李郁芳 3袁丹1
作者信息
- 1. 100076 北京航天总医院神经内科
- 2. 首都医科大学宣武医院介入放射诊断治疗科
- 3. 100076 北京航天总医院影像中心
- 折叠
摘要
Abstract
Objective To investigate the efficacy and safety of arterial thrombolysis in combination with angioplasty in the treatment of patients with vertebrobasilar ischemic stroke in 6 hours. Methods Twenty-one patients with acute vertebrobasilar ischemic stroke were collected from April 2006 to February 2012. They were divided into either an intra-arterial thrombolysis group (n = 10) or an intra-arte-rial thrombolysis combined with angioplasty group (n = 11) according to the different treatments. Four of the later group underwent routine balloon angioplasty and stenting, 1 underwent stenting, and 6 underwent balloon dilatation only. Vascular recanalization was determined according to the thrombolysis in myocardial infarction (TIMI) criteria. The National Institutes of Health Stroke Scale (NIHSS) scores were used to evaluate the neurological function before and after treatment. The effectiveness of thrombolysis after 3 months was evaluated according to the modified Rankin scale (mRS). Results ① One patient (10.0% ) had complete recanalization in the intra-arterial thrombolysis group and 6 (54.5% ) had complete recanalization in the intra-arterial thrombolysis combined with angioplasty group. There was significant difference between the 2 groups. ②After treatment, the NIHSS scores of both the intra-arterial thrombolysis group and the intra-arterial thrombolysis combined with angioplasty group were decreased, but there were no significant differences in the NIHSS scores immediately after surgery, 24 hours after surgery and 2 weeks after surgery between the 2 groups. ③There was no significant difference in the mortality and the effectiveness during the follow up period between the 2 groups. ④Five patients who successfully conducted stenting had complete recanalization. No restenosis was observed during the follow-up period after surgery, thrombolysis jointly simple balloon dilatation in 6 patients, only two cases had been re-pass (one case was complete re-canalization) , including 1 patient who was followed 3 months had restenosis. Conclusion With simple arterial thrombolysis can not be recanalizalion of the vertebrobasilar artery system in patients with acute is-chemic stroke, arterial thrombolysis combined with angioplasty may improve recanalization rates; stenting compared with simple balloon dilatation efficacy may be better.关键词
椎底动脉供血不足/卒中/血栓溶解疗法/血管成形术/支架Key words
Vertebrobasilar insufficiency/ Stroke / Thrombolytic therapy / Angioplasty / Stents引用本文复制引用
李慧英,蒋初明,缪中荣,李郁芳,袁丹..动脉内溶栓联合血管成形术治疗发病六小时内椎-基底动脉系统缺血性卒中患者的疗效[J].中国脑血管病杂志,2012,9(4):183-188,6.
