CAJ | 학술논문

目的评估急诊支架置入术治疗后循环急性脑梗死的可行性和安全性.方法 2010年3月-2011年8月,共对6例后循环急性脑梗死患者进行急诊支架置入术治疗；入选标准:后循环急性脑梗死时间窗超过6h,有明确头颅CT低密度灶,椎或基底动脉狭窄≥70％或闭塞,无支架置入术禁忌证.手术前、后按现标准服药及常规处理,采用球扩或自膨支架,技术成功包括血管造影和装置使用成功.所有病人在术前和术后均接受NIHSS评分,完整地评估神经专科的情况.结果患者平均年龄为(66±10)岁,均为男性,5例昏迷,1例昏睡；3例患糖尿病,4例患高血压病,1例有心肌梗死病史,3例嗜烟；靶病变:3例基底动脉闭塞、1例基底动脉次全闭塞、2例双侧椎动脉闭塞,分别对以上病例成功置入了6枚球扩支架和1枚自膨式支架,技术成功率为100％;除1例死亡,其余均存活,术后NIHSS评分较术前好转.结论在后循环急性脑梗死危重患者中,应用急诊支架置入术将有望成为其可行的治疗手段之一.
목적 평고급진지가치입술치료후순배급성뇌경사적가행성화안전성.방법 2010년3월-2011년8월,공대6례후순배급성뇌경사환자진행급진지가치입술치료；입선표준:후순배급성뇌경사시간창초과6h,유명학두로CT저밀도조,추혹기저동맥협착≥70％혹폐새,무지가치입술금기증.수술전、후안현표준복약급상규처리,채용구확혹자팽지가,기술성공포괄혈관조영화장치사용성공.소유병인재술전화술후균접수NIHSS평분,완정지평고신경전과적정황.결과 환자평균년령위(66±10)세,균위남성,5례혼미,1례혼수；3례환당뇨병,4례환고혈압병,1례유심기경사병사,3례기연；파병변:3례기저동맥폐새、1례기저동맥차전폐새、2례쌍측추동맥폐새,분별대이상병례성공치입료6매구확지가화1매자팽식지가,기술성공솔위100％;제1례사망,기여균존활,술후NIHSS평분교술전호전.결론 재후순배급성뇌경사위중환자중,응용급진지가치입술장유망성위기가행적치료수단지일.
Objective To assess the efficacy and safety of emergent stenting for acute posterior circulation cerebral infarct.Methods Emergent stenting was performed in 6 patients with acute posterior cerebral infarct during March 2010 to October 2011.Criteria:the time of cerebral infarct in posterior circulation exceeded 6 hours,obviously low density shadow in cranium CT scan,stenosis ≥70％ or obstruction in basilar or vertebral artery,no contraindication to stenting performance.The patients were treated regularly before and post surgery and then received self-expanding stent or balloon-expanding stents through angiography.Their neurological status was assessed with NIHSS.Results The average ages of the patients were ( 66 ± 10 ) years old,all were males,including 5 in coma,1 in spoor,3 with diabetes,4 with hyperpiesia,1 with cardiac infarct history,and 3 addicted to tobacco.There were 3 vertebral artery obstructions,1 vertebral artery sub-total occlusion,and 2 bilateral vertebral artery occlusion.One self-expanding stent and 6 balloonexpanding stents were successfully placed at all the target artery,with a technical success rate of 100％.All the patients survived except one death.The postoperative NIHSS scores were better than the baselines.Conclusions Emergent stenting is likely to become one of the feasible approach in the treatment of acute posterior circulation cerebral infarct.