急性脑梗死动脉内溶栓治疗致靶血管早期再闭塞的若干问题探讨

目的探讨局部动脉内溶栓治疗急性缺血性脑梗死致靶血管早期再闭塞的可能性、时间及其相应处理措施。方法217例急性缺血性脑梗死患者应用尿激酶或爱通立(rt-PA)行局部动脉内溶栓治疗,发生靶血管早期再闭塞3例(1.38%)。结果颈内动脉末端、大脑中动脉、基底动脉各1例;重度伤残1例,死亡2例。结论急性脑梗死动脉内溶栓治疗过程中可并发靶血管的早期再闭塞,可能与溶栓后破碎栓子、斑块随血流移位栓塞远端的血管及局部的血栓再形成有关,靶血管早期再闭塞有较高的死亡率。

Early reocclusion of the target vessel during intra-arterial thrombolysis for acute ischemic stroke

Objective To investigate the possibility and prevent measures of early reocclusion of the target vessel during intra-arterial thrombolysis for acute ischemic stroke.Methods Three patients occurred early reocclusion of the target vessel in 217 patients treated for acute ischemic stroke with local intra-arterial thrombolysis at our hospital(1.38%).Early reocclusion of the target vessel was defined as increasing stenosis or complete closure of the relative vessel of thrombolysis during intra-arterial thrombolysis treatment,or occlusion recurring of partial initial recanalized arteries documented by angiography.Results One patient occurred reocclusion in internal carotid artery segment,one in the middle cerebral artery segment,one in the vertebrobasilar artery segment.2 patients died,1 survived but severe disability at 3 months.Conclusion The target vessel early reocclusion occurs during intra-arterial thrombolysis for ischemic stroke.High severe disability were found in patient of early reocclusion of the target vessel.