超选择性动脉溶栓联合血管内干预治疗急性缺血性脑卒中的临床探讨

目的探讨超选择性动脉溶栓联合血管内干预治疗急性缺血性脑卒中的疗效和安全性。方法回顾分析我院住院治疗的21例进行超选择性动脉溶栓的急性缺血性脑卒中患者的临床资料。结果21例患者中，颈内动脉系统病变16例．其中颈内动脉闭塞2例，大脑中动脉主干及分支闭塞6例，大脑前动脉闭塞1例，脑血管造影未见异常者7例。椎基底动脉闭塞5例，闭塞血管再通者，大脑中动脉4例，椎基底动脉2例。其中7例患者动脉溶栓的同时进行了血管内治疗，5例球囊成形术和2例支架植入术。临床症状完全恢复7例，明显好转或进步8例，无效3例，死亡3例；溶栓后脑出血2例．存活病例无1例并发脑出血及消化道出血。结论对选择的急性缺血性脑卒中患者进行超选择性动脉溶栓联合血管内干预治疗是安全有效的。

Clinical research of superselective intra-arterial thrombolysis combined endovascular treatment for acute ischemic stroke

Objective To evaluate the effect and safety of superselective intra-arterial thrombolysis Combined Endovascular Treatment for acute ischemic stroke. Methods To review the 21cases of acute ischemic stroke who were treated by superselective intra-arterial thrombolysis, and analysis their clinical information. Results Superselective intra-arterial thrombolysis were carried out on 21 cases of acute ischemic stroke patients during July 2006 through May 2008, two occlusions were found in ICA, six in middle cerebral artery mainstem and branches, one in anterior cerebral artery, no obvious abnormality was identified in 7 cases.five in vetebral-basal artery, four recanalizations were achieved in MCA occlusions, two in vetebralbasal artery. Of all casas,5 casas for supplied balloon angioplasty,2 for Stent Implantation.The nervous system symptoMs of 7 cases recovered completely, satisfactirily or improvement in 8 and 3 cases died. Intracranial hemorrhage were happened to 2 patients. Conclusion Superselective intra-arterial thrombolysis was safe and effective for selected acute ischemic stroke.