静脉溶栓桥接Solitaire支架取栓治疗急性缺血性脑卒中的效果分析

目的探讨静脉溶栓桥接Solitaire支架取栓开通颅内闭塞大血管的疗效。 方法回顾我院2014年6月—2015年10月采用桥接模式接受血管内治疗的15例急性缺血性脑卒中患者资料。分析大血管开通情况，术中、术后并发症发生情况，早期神经功能改善情况以及随访90 d时mRS情况。 结果15例患者中，大脑中动脉闭塞9例，颈内动脉颅内段合并大脑中动脉闭塞2例，椎基底动脉系统闭塞4例。所有患者大血管均获得开通。2例患者出现颅内出血，1例为颞叶出血、1例为丘脑出血。死亡2例。入院NIHSS评分(14.83±5.65)与3天后NIHSS评分(6.82±5.53)比较，差异有统计学意义。90 d随访临床结果优良患者9例(mRS<2)。 结论静脉溶栓桥接Solitaire支架动脉取栓能使大血管获得较好的再通率，显著改善急性缺血性脑卒中患者的预后。

Effect of intraveneous thrombolysis bridged endovascular thrombectomy with the solitaire stent retriever in treatment of patients with acute cerebral infarction

ObjectiveTo investigate the effective of intraveneous thrombolysis bridged endovascular thrombectomy with the Solitaire stent retriever in treatment of patients with acute cerebral infarction. MethodsThis study retrospectively analyzed 15 patients with acute ischemic stroke underwent bridged endovascular thrombectomy between June 2014 and October 2015.The coprimary outcomes included reperfusion immediately and complications and early neurologic improvement. Secondary outcomes were the functional score on the modified Rankin scale at 90 days. ResultsAll Patients with a proximal intracranial occlusion, including middle cerebral artery 9, internal carotid 2 and posterior circulation 4 patients, obtained reperfusion at once. Symptomatic intracerebral hemorrhage occurred in 2 patients located at temporal lobe and thalamus. Two patients died. The scores of the National Institutes of Health stroke scale (NIHSS) were decreased after 3 days (14.83±5.65 vs. 6.82±5.53, P<0.01). Nine patients had good functional independence (90-day modified Rankin score of 0 to 2). ConclusionsIntraveneous thrombolysis bridged early thrombectomy with the Solitaire stent retriever improved reperfusion, early neurologic recovery, and functional outcome.