椎-基底动脉血栓形成介入治疗36例分析

目的 研究椎一基底动脉血栓形成血管内介入治疗的方法与疗效的相关性。方法 将6-F导引导管置于C5水平，用Magic 3F/2F或Target溶栓微导管超选椎-基底动脉，尿激酶100万U，分血栓接触性和非接触性溶栓两组。结果 血管再通率100％，其中3l例存活(86．1％)，5例死亡，遗留舌咽神经不全麻痹9例，小脑共济失调4例，轻偏瘫5例，缄默症2例，视野缺损2例。结论 两种溶栓方法均可以使椎-基底动脉主干再通并获得显著的临床改善，但非接触性溶栓由于可以延迟这一干流的再通时间这样可以保持血管局部有较高的灌注压和血药浓度，更利于主干的主要分支及脑干穿通支的再通，最大限度地恢复缺血区的血液动力学改变和获得更显著的临床效果：

Interventional treatment of vertebrobasilar artery thrombosis: A report of 36 cases

Objective To study the relationship of methods and effects in interventional treatment of vertebrobasilar artery thrombosis.Methods First located the6-F guide catheter on C 5 level,then microselected into vertebrobasilar artery by Magic3F?2F or Target microcatheter.1,000,000unit of Urokinase was injected.Thrombus-contact group(15cases)and non-thrombus-contact(21cases)group were separated.Results Arterial recanalization rate was100%.31cases survived(86.1%)and5cases died.Incompletely glossopharyngeal palsy occurred in9cases,cerebellar ataxia in4cases,light hemiplegia in5cases,mutism in2cases and visual field defect in2cases.Conclusion Recanalization of the vertebrobasilar trunk and obvious clinical improvement could be attained by the two different thrombolytic methods.The non-contact thrombolysis may delay recanalization of the vertebrobasilar trunk so as to keep the perfusion pressure and the blood medicine concentration higher in the local vessel and contribute more to recanalization of the major branches and brainstem-perforating branches.The non-contact thrombolysis can recover hemodynamic changes in the ischemic area to the most extent and attain the more significant clinical effects