临床神经病学杂志2025，Vol.38Issue(5)：349-355,7.
前循环颅内动脉粥样硬化性狭窄所致急性大血管闭塞性缺血性脑卒中的介入治疗:一项疗效与安全性评估
Interventional treatment for acute occlusive stroke caused by anterior circulation intracranial atherosclerotic stenosis:an efficacy and safety assessment
摘要
Abstract
Objective To explore the application selection and clinical effects of different vascular recanalization techniques in acute ischemic stroke with large artery occlusion(AIS-LVO)induced by anterior circulation intracranial atherosclerotic stenosis(ICAS).Methods Retrospectively,156 AIS-LVO patients caused by anterior circulation ICAS,who were admitted to Xuzhou Central Hospital from January 2022 to September 2024,were included.The patients were divided into three groups according to the surgical methods.The baseline data,endovascular treatment related data,postoperative efficacy and safety indicators of patients were analyzed statistically.The influencing factors of prognosis were analyzed usinga multi-factor Logistic regression model.Results The final enrollment result was 70 patients in thrombectomy-only group,48 patients in thrombectomy combined with balloon dilation group,and 38 patients in thrombectomy combined with stenting group.There was a statistically significant difference in the proportion of hyperlipidemia among the three groups before treatment(P＜0.05).However,further analysis revealed that there was no difference between any two groups.The time from puncture to recanalization in the thrombectomy-only group was significantly lower than that in the other two groups(all P＜0.05).After treatment,the restenosis rate in the thrombectomy combined with stenting group was significantly lower than the other two groups,while the intracerebral hemorrhage rate was significantly higher(all P＜0.05).Multivariate Logistic regression analysis showed that the NIHSS score at admission was an independent risk factor for prognosis(OR=2.780,95％CI:1.212-6.374,P=0.016).Conclusion For AIS-LVO induced by anterior circulation ICAS,salvage balloon dilation or stenting after thrombectomy alone is safe and effective,resulting in a good prognosis for most patients and a reduced rate of restenosis.关键词
颅内动脉粥样硬化性狭窄/机械取栓术/球囊扩张血管成形术/支架植入术Key words
intracranial atherosclerotic stenosis/mechanical thrombectomy/balloon dilation angioplasty/stenting分类
医药卫生引用本文复制引用
李怡萍,蒋兰,孙梦飞,傅新民..前循环颅内动脉粥样硬化性狭窄所致急性大血管闭塞性缺血性脑卒中的介入治疗:一项疗效与安全性评估[J].临床神经病学杂志,2025,38(5):349-355,7.基金项目
徐州市科技项目(KC21224) （KC21224）
