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中华介入放射学电子杂志

中华介入放射学电子杂志 ›› 2015, Vol. 03 ›› Issue (04) : 179 -182. doi: 10.3877/cma.j.issn.2095-5782.2015.04.001

所属专题： 文献；

神经介入

静脉溶栓桥接Solitaire支架取栓治疗急性缺血性脑卒中的效果分析
吕朋华1, 李晓波2,†(), 孙陵1, 陈蓓蕾2, 景坚2, 王书祥1, 徐川1, 王福安1, 耿素萍1, 蔡明玉1, 黄文诺1, 葛俊1   
  1. 1. 225001　江苏省苏北人民医院，扬州大学临床医学院介入放射科
    2. 225001　江苏省苏北人民医院，扬州大学临床医学院神经内科
  • 收稿日期:2015-10-14 出版日期:2015-11-01
  • 通信作者: 李晓波

Effect of intraveneous thrombolysis bridged endovascular thrombectomy with the solitaire stent retriever in treatment of patients with acute cerebral infarction

Penghua Lyu1, Xiaobo Li2,†(), Ling Sun1, Beilei Chen2, Jian Jing2, Shuxiang Wang1, Chuan Xu1, Fuan Wang1, Suping Geng1, Mingyu Cai1, Wennuo Huang1, Jun Ge1   

  1. 1. Department of Interventional Radiology, Northern Jiangsu People's Hospital, Clinical Medical School and Affiliated Hospital of Yangzhou University, Yangzhou 225001, China
  • Received:2015-10-14 Published:2015-11-01
  • Corresponding author: Xiaobo Li
  • About author:
    Corresponding author: Li Xiaobo, Email:
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吕朋华, 李晓波, 孙陵, 陈蓓蕾, 景坚, 王书祥, 徐川, 王福安, 耿素萍, 蔡明玉, 黄文诺, 葛俊. 静脉溶栓桥接Solitaire支架取栓治疗急性缺血性脑卒中的效果分析[J/OL]. 中华介入放射学电子杂志, 2015, 03(04): 179-182.

Penghua Lyu, Xiaobo Li, Ling Sun, Beilei Chen, Jian Jing, Shuxiang Wang, Chuan Xu, Fuan Wang, Suping Geng, Mingyu Cai, Wennuo Huang, Jun Ge. Effect of intraveneous thrombolysis bridged endovascular thrombectomy with the solitaire stent retriever in treatment of patients with acute cerebral infarction[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2015, 03(04): 179-182.

目的

探讨静脉溶栓桥接Solitaire支架取栓开通颅内闭塞大血管的疗效。

方法

回顾我院2014年6月—2015年10月采用桥接模式接受血管内治疗的15例急性缺血性脑卒中患者资料。分析大血管开通情况，术中、术后并发症发生情况，早期神经功能改善情况以及随访90 d时mRS情况。

结果

15例患者中，大脑中动脉闭塞9例，颈内动脉颅内段合并大脑中动脉闭塞2例，椎基底动脉系统闭塞4例。所有患者大血管均获得开通。2例患者出现颅内出血，1例为颞叶出血、1例为丘脑出血。死亡2例。入院NIHSS评分(14.83±5.65)与3天后NIHSS评分(6.82±5.53)比较，差异有统计学意义。90 d随访临床结果优良患者9例(mRS<2)。

结论

静脉溶栓桥接Solitaire支架动脉取栓能使大血管获得较好的再通率，显著改善急性缺血性脑卒中患者的预后。

关键词: 桥接, 溶栓, Solitaire，支架, 急性卒中
Objective

To investigate the effective of intraveneous thrombolysis bridged endovascular thrombectomy with the Solitaire stent retriever in treatment of patients with acute cerebral infarction.

Methods

This study retrospectively analyzed 15 patients with acute ischemic stroke underwent bridged endovascular thrombectomy between June 2014 and October 2015.The coprimary outcomes included reperfusion immediately and complications and early neurologic improvement. Secondary outcomes were the functional score on the modified Rankin scale at 90 days.

Results

All Patients with a proximal intracranial occlusion, including middle cerebral artery 9, internal carotid 2 and posterior circulation 4 patients, obtained reperfusion at once. Symptomatic intracerebral hemorrhage occurred in 2 patients located at temporal lobe and thalamus. Two patients died. The scores of the National Institutes of Health stroke scale (NIHSS) were decreased after 3 days (14.83±5.65 vs. 6.82±5.53, P<0.01). Nine patients had good functional independence (90-day modified Rankin score of 0 to 2).

Conclusions

Intraveneous thrombolysis bridged early thrombectomy with the Solitaire stent retriever improved reperfusion, early neurologic recovery, and functional outcome.

Key words: Bridged, Thrombolysis, Solitaire, Stent, Acute stroke
图1 支架取栓前后患者的头颅CTA及DSA表现。术前头颅CTA（图A）以及术中DSA（图B）提示左侧大脑中动脉M1中段以远闭塞；C图示支架取栓后左侧大脑中动脉通畅；D图示随访头颅CTA左侧大脑中动脉通畅。
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