西安交通大学学报（医学版）2025，Vol.46Issue(6)：916-924,9.DOI:10.7652/jdyxb202506004
血管内治疗症状性急性颈内动脉闭塞疗效的回顾性分析
A retrospective study of the efficacy of endovascular therapy for acute symptoms of internal carotid artery occlusion
摘要
Abstract
Objective To explore the influencing factors of poor prognosis after successful recanalization of symptomatic acute internal carotid artery occlusion(AICAO)by applying endovascular therapy(EVT)technology.Methods We made a retrospective analysis of the clinical and imaging data of 62 symptomatic AICAO patients.After collateral evaluation and recanalization therapy,we obtained flat CT and DSA images,together with the findings of the collateral circulation assessment.At 24.0±6.0 hours after surgery,head plain CT scans were reexamined,and at 14 days after surgery or at discharge,neurological function was assessed using the NIHSS scale.Using the modified Rankin scale,we assessed neurological function and prognosis over a 90-day period.Results Each of the 62 patients had a TICI grade of 2b or 3 and was successfully recanalized.On average,it took 124.36±66.31 minutes from puncture to recanalization.Two instances involved iatrogenic dissection,while twelve cases had intraoperative distal thrombus escape episodes.Of all the patients,32 ones(51.6％)had a fair prognosis,whereas 30 patients(48.4％)had a bad prognosis.The two patient groups differed significantly in the ASPECT score,preoperative NIHSS score,intraoperative balloon catheter usage,postoperative 24 hour and 14 days NIHSS score,postoperative 14 days neurological function,and all-cause mortality within 90 days(all P＜0.05).The best intervention threshold for preoperative NIHSS score was 11.5 points,and both the preoperative NIHSS score and intraoperative BGC utilization were independent predictors influencing poor outcome.Conclusion The preoperative NIHSS score and intraoperative BGC usage are independent predictors of 90-day poor prognosis in AICAO patients with symptomatic AICAO who underwent successful recanalization via endovascular therapy.关键词
急性颈内动脉闭塞(AICAO)/机械取栓/心源性栓塞/串行病变/动脉夹层/血管内治疗(EVT)/颈内动脉内膜剥脱术/颈动脉支架植入术Key words
acute internal carotid artery occlusion(AICAO)/mechanical thrombectomy/cardioembolic stroke/tandem lesion/arterial dissection/endovascular therapy(EVT)/internal carotid artery endarterectomy/carotid artery stent implantation surgery分类
临床医学引用本文复制引用
张品元,张吉人,赵冬曼,齐石磊,杜国英,杨健..血管内治疗症状性急性颈内动脉闭塞疗效的回顾性分析[J].西安交通大学学报（医学版）,2025,46(6):916-924,9.基金项目
河北省政府资助专科能力建设和专科带头人培养项目(No.361005)Supported by Foundation of Hebei Province for Specialized Ability Building and Specialized Leader Training(No.361005) （No.361005）
