急性基底动脉闭塞后行Solitaire AB型支架取栓术六例

目的 探讨Solitaire AB型支架用于急性基底动脉闭塞后动脉取内栓的效果及安全性 方法 回顾性分析2010年5-11月广东省中医院脑病中心采用Solitaire AB型支架进行急性基底动脉闭塞后动脉取栓术6例,若治疗后残余狭窄率≥50%则同时行支架成形术.分析其即时取栓效果,术后出血情况,比较患者治疗前后NIHSS评分及预后情况.结果 ①6例患者经1～3次取栓后,基底动脉均获得冉通;对其中5例有残余狭窄者联合使用球囊扩张支架成形术.②1例患者支架释放后.支架内急性血栓形成,经处理后复查造影显示基底动脉通畅.③5例患者术后3～7d复查头部MRI,均未见脑梗死灶扩大,基底动脉通畅.1例患者术后1 d脑出血,7d后死亡.④5例患者出院时NIHSS评分较入院时降低2～15分;5例患者出院时改良Ptaglkin评分0分1例,1分2例,2分2例.结论 在急性基底动脉血栓形成的患者中,使用Solitaire AB型支架取栓术是相对安全、有效的,患者预后良好.

Mechanical embolectomy with the Solitaire AB device after acute basilar artery thrombosis:a report of 6 cases

Objective To evaluate the efficacy and safety of arterial embolectomy with the Solitaire AB stent after acute basilar artery thrombosis. Methods Six patients performed arterial embolectomy with the Solitaire AB stent after acute basilar artery thrombosis in the Encephalopathy Center, Guangdong Province Hospital of Traditional Chinese Medicine from May to November 2010 were analyzed retrospectively. Stent angioplasty was performed for patients with residual stenosis ≥50%. Their immediate effect of throm- bectomy and postoperative bleeding were analyzed. The National Institutes of Health Stroke Scale （NIHSS） scores and the prognosis were compared before and after the treatment. Results ①After 1 to 2 embolectomies, the basilar arteries of the 6 patients were revascularized, in 5 patients with residual stenosis were treated in combination with balloon angioplasty and stenting. ②One patient had acute in-stent thrombosis after the release of stent. The angioplasty re-examination showed that the basilar artery was patent after the treatment. ③5 patients were re-examined by MRI 3 to 7 days after procedure. There were no significant expansion of cerebral infarction, and their basilar arteries were patent. One patient had cerebral hemorrhage 1 day after procedure, and he died after 7 days. ④The NIHSS scores were lowered 2 - 15 at dischange than at admission in 5 patients. The modified Rankin Scale （mRS） scores in 5 patients were 0（ 1 patient）, 1 （2 patients）, and 2（2 patients） at discharge. Conclusion Using Solitaire AB stent and embolectomy are relatively safe and effective in patients with acute basilar artery thrombosis, and the prognosis of patients is good.