| 引用本文： |
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徐一,冀涛,陈刘炜,等.Enterprise支架治疗颅内动脉粥样硬化性狭窄致急性大血管闭塞疗效分析[J].同济大学学报（医学版）,2022,43(3):372-379. [点击复制]
- XU Yi,JI Tao,CHEN Liuwei,et al.Efficacy of Enterprise stent for revascularization of intracranial atherosclerosis stenosis induced acute large vessel occlusion[J].同济大学学报（医学版）,2022,43(3):372-379. [点击复制]
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| 摘要: |
| 目的探讨Enterprise支架在颅内动脉粥样硬化性狭窄致急性大血管闭塞（intracranial atherosclerosis stenosis induced acute large vessel occlusion, ICAS-LVO）患者的治疗中的安全性和有效性。方法回顾性收集并分析2020年1月至2021年9月在同济大学附属第十人民医院神经外科诊断为ICAS-LVO，且术中置入Enterprise支架的58例连续患者的临床资料，包括人口统计学资料、影像学资料、治疗情况、血管再通情况、预后和随访结果等。结果纳入的58例患者中男性45例（77.6%），女性13例（22.4%），中位年龄为65（59~69）岁，中位入院NIHSS评分为12（10,16）分。闭塞部位分布： 颈内动脉颅内段6例（10.3%），大脑中动脉M1/M2段33例（56.9%），椎动脉颅内段9例（15.5%），基底动脉10例（17.2%）。术后57例（98.3%）患者实现了成功再通（mTICI≥2b）。4例（6.9%）患者出现了恶性脑水肿；11例（19.0%）患者发生了出血转化，其中2例（3.4%）为症状性颅内出血。3个月随访，39例（67.2%）患者预后良好（改良Rankin量表评分≤2分），1例（1.7%）患者死亡。34例患者接受了DSA或CTA随访，其中4例（11.8%）发生支架内再狭窄。结论颅内动脉粥样硬化性狭窄基础上急性大血管闭塞的患者，在取栓后球囊扩张联合Enterprise支架置入具有良好的安全性及有效性，具有较好的临床应用前景。 |
| 关键词: 颅内动脉粥样硬化性狭窄 急性大血管闭塞 Enterprise支架 血管内治疗 |
| DOI：10.12289/j.issn.1008-0392.22066 |
| 投稿时间：2022-02-21 |
| 基金项目: |
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| Efficacy of Enterprise stent for revascularization of intracranial atherosclerosis stenosis induced acute large vessel occlusion |
| XU Yi,JI Tao,CHEN Liuwei,LI Lei,ZHANG Quanbin |
| (Department of Neurosurgery, Shanghai Tenth People’s Hospital, Nanjing Medical University, Shanghai 200072, China;Department of Neurosurgery, Shanghai Tenth People’s Hospital, School of Medcine, Tongji University, Shanghai 200072, China) |
| Abstract: |
| ObjectiveTo explore the safety and efficacy of Enterprise stent in the treatment for Intracranial Atherosclerosis Stenosis induced acute Large Vessel Occlusion（ICAS-LVO). MethodsClinical data of 58 consecutive patients diagnosed as ICAS-LVO, who underwent endovascular treatment by Enterprise implantation in the Department of Neurosurgery, Shanghai Tenth People’s Hospital from January 2020 to September 2021, were retrospectively analyzed. Demographic characteristics, imaging findings, treatment, revascularization, prognosis and follow-up results of patients were collected and evaluated. ResultsAmong 58 patients, there were 45 males（77.67%) and 13 females（22.4%) with a median age of 65（59,69) years, and a median admission NIHSS score of 12（10,16). The occlusions were located in the intracranial segment of internal carotid artery in 6 cases（10.3%)， in the M1/M2 segment of middle cerebral artery in 33 cases（56.9%)， in the intracranial segment of vertebral artery in 9 cases（15.5%) and in basilar artery in 10 cases（17.2%) . Successful recanalization was achieved in 57 patients（98.3%)（mTICI≥2b); 4 patients（6.9%) developed malignant cerebral edema; 11 patients（19.0%) experienced hemorrhagic transformation, including 2 cases of（3.4%) symptomatic intracranial hemorrhage. At 3-month follow-up, 39 patients（67.2%) had a good prognosis（modified Rankin scale score≤2) and 1 patient（1.7%) died. Thirty-four patients underwent DSA or CTA follow-up, of whom 4（11.8%) developed in-stent restenosis. ConclusionFor patients with intracranial atherosclerosis stenosis-induced acute large vessel occlusion, balloon dilation combined with Enterprise stent implantation after thrombectomy is safe and effective, being promising in clinical application prospect. |
| Key words: intracranial atherosclerosis stenosis acute large vessel occlusion Enterprise stent endovascular treatment |
