CAJ | 학술논문

目的探讨血管内多模式复流治疗(MMRT)开通急性颈内动脉和大脑中动脉串联(TIM)闭塞的安全性和疗效.方法回顾性分析本中心搜集的急性TIM闭塞相关病例6例,分析其发病机制,串联闭塞部位和代偿程度、梗死灶位置和大小,结合机械开通TIM闭塞的技术方法及手术并发症,比较手术前后的美国围立卫生研究院卒中量表(NIHSS)评分的变化和影像资料,采用改良Rankin评分(modified Rankin scale,mRS)评估患者预后.结果 6例TIM闭塞患者,术前NIHSS评分为13 ～20分,手术时间为60 ～ 230 min,实质性开通5例,均未发生症状性出血.术后3d和出院时NIHSS评分分别为7～19分和3～17分,1例患者出院1个月后因肺部感染死亡.3个月时mRS评分为0、2、3和5分者分别为1、1、2、1例.结论急性TIM闭塞血管内治疗复杂,MMRT开通此类闭塞相对安全、有效.
목적 탐토혈관내다모식복류치료(MMRT)개통급성경내동맥화대뇌중동맥천련(TIM)폐새적안전성화료효.방법 회고성분석본중심수집적급성TIM폐새상관병례6례,분석기발병궤제,천련폐새부위화대상정도、경사조위치화대소,결합궤계개통TIM폐새적기술방법급수술병발증,비교수술전후적미국위립위생연구원졸중량표(NIHSS)평분적변화화영상자료,채용개량Rankin평분(modified Rankin scale,mRS)평고환자예후.결과 6례TIM폐새환자,술전NIHSS평분위13 ～20분,수술시간위60 ～ 230 min,실질성개통5례,균미발생증상성출혈.술후3d화출원시NIHSS평분분별위7～19분화3～17분,1례환자출원1개월후인폐부감염사망.3개월시mRS평분위0、2、3화5분자분별위1、1、2、1례.결론 급성TIM폐새혈관내치료복잡,MMRT개통차류폐새상대안전、유효.
Objective To evaluate the safety and efficacy of multimodal reperfusion therapy (MMRT) for acute tandem internal carotid artery and middle cerebral artery (TIM)occlusions.Methods Six cases of TIM occlusions were analyzed retrospectively,including etiology,sites of tandem occlusion,compensation,location and size of infarcts,mechanical recanalization technique and its complications.Changes of National Institute of Health Stroke Scale (NIHSS) score and image findings between pre-and post-procedure were further compared.The modified Rankin scores (mRS) were used to assess clinical prognosis.Results The NIHSS score on admission was 13-20,and the time of procedure ranged 60-230 min.Five cases was substantial recanalized and no symptomatic intracerebral hemorrhage was observed.The NIHSS scores of the patients on day 3 after surgery were 7-19,and those were 3-17 when being discharged.One patient died of pulmonary infection 1 month after discharge.For the 5 patients who survived,the modified Rankin Scale (mRS) was evaluated at 3 months with scores of 0,2,3,3 and 5,respectively.Conclusions Endovascular therapy for acute TIM occlusions are complex,MMRT may be relatively safe and effective.