动脉溶栓治疗急性颈内动脉闭塞所致缺血性脑梗死

目的观察动脉溶栓治疗急性颈内动脉闭塞所致缺血性脑梗死的疗效及并发症。方法对10例发病在6h内的患者行动脉溶栓治疗,并对其中2例辅以经皮腔内血管成形术(PTA)或颈动脉内膜剥脱术(CEA)治疗。血管再通程度用TIMI分级评价。临床结果评价在溶栓后30d进行,根据ModifiedRankinScale(MRS)分类。结果溶栓前10例患者均为TIMI0～1,溶栓后8例部分/完全再通,其中7例结果良好(MRS0～3)。发生症状性脑出血2例(10%)。结论症状发作6h内的动脉溶栓可明显改善急性颈内动脉闭塞所致缺血性脑梗死患者的预后,降低死亡率。

Intra-arterial thrombolysis in patients with acute ischemic stroke of the cervical internal carotid artery occlusive disease

Objective To observe the safety and efficacy of local intra-arterial thrombo lysis(LIT)in patients with acute ischemic stroke of cervical internal carotid artery occlusive disease.Methods 10patients were treated by LIT.2of10pati ents were further treated by either angioplasy or endarterectomy.Primary neuror adiological assessment was performed with CT in all patients.Angiographic reca nalization level was classified according to thrombolysis in myocardial infarcti on(TIMI )grades.Clinical outcome was classified as good for Modified Rankin Scale(MRS)scores of0to3and as poor for MRS scores of4to6.Results Complete /partial recanalization after infusion was accomplished in8patients,seven of w hom had good clinical outcome.Cerebral hemorrhage occurred in2of10patients. Conclusion The results of this study suggest that LIT may be helpful to improve the outcome in patients with acute cervical internal carotid artery occlusive disease if it is performed within6hours of stroke onset.