急诊血管内支架置入治疗11例急性创伤性颈内动脉夹层形成的疗效分析

目的探讨急诊血管内支架置入治疗创伤性颈内动脉夹层形成的效果、安全性及急性创伤性颈内动脉夹层的手术适应证。方法选取2015年9月～2018年9月本院收治的11例接受急诊血管内支架置入治疗的急性创伤性颈内动脉夹层患者为研究对象,根据术前CTA、术前及术后DWI+MRI脑血流灌注分期、TICI血流分级、NIHSS评分,评价其疗效、围手术期的安全性及手术相关适应证。结果11例患者均有明确头颈部外伤史,患者术后血流灌注均明显改善。结论急诊支架置入治疗急性创伤性颈内动脉夹层是安全有效的。影像学评估血流灌注不足达Ⅱ期或血流灌注不足伴缺血症状发作或狭窄程度大于70%,均应积极手术治疗。

Therapeutic effect of emergency endovascular stent placement in the treatment of 11 cases of acute traumatic internal carotid artery dissection

Objective?To explore the effect and safety of emergency endovascular stent placement in the treatment of traumatic internal carotid artery dissection,and the surgical indications of acute traumatic internal carotid artery dissection.Methods?Eleven patients with acute traumatic internal carotid artery dissection treated with emergency endovascular stent placement enrolled in our hospital from September 2015 to September 2018 were selected.The efficacy,perioperative safety and surgical related indications were evaluated according to preoperative CTA,preoperative and postoperative DWI+MRI brain blood perfusion staging,TICI blood flow grading,and NIHSS scores.Results?The 11 patients all had a history of head and neck trauma.All the patients had significant improvement in postoperative blood flow irrigation.Conclusion?Emergency stent placement is safe and effective in the treatment of acute traumatic internal carotid artery dissection.Positive surgical treatment should be conducted in cases of stage II hypoperfusion or hypoperfusion combined with ischemic symptoms or stenosis greater than 70%.