医学
闭塞
颈动脉
脑动脉
大脑中动脉
血管内治疗
颈内动脉
心脏病学
内科学
放射科
缺血
动脉瘤
作者
А И Хрипун,А. В. Саликов,А Б Миронков,A D Pryamikov,S A Asratyan,V. S. Suryakhin,П Р Камчатнов,O.A. Sazhina,Konstantin Zakharov
出处
期刊:Zhurnal Nevrologii I Psikhiatrii Imeni S S Korsakova
[Media Sphere Publishing Group]
日期:2020-01-01
卷期号:120 (12): 5-5
被引量:1
标识
DOI:10.17116/jnevro20201201225
摘要
OBJECTIVE To evaluate the results of endovascular treatment of patients with ischemic stroke caused by acute tandem occlusion of the internal carotid and middle cerebral arteries (ICA and MCA). MATERIAL AND METHODS Endovascular intervention was performed in 8 patients with tandem occlusion of ICA and MCA. The neurological deficit on admission was 17.4±5.6 NIHSS points and the average ASPECTS score was 9.5±0.8. The time from the onset of neurological symptoms to reperfusion was 224±68 min. Thrombolytic therapy was initiated before brain revascularization and continued intraoperatively in 4 out of 8 patients. ICA stenting after aspiration thrombectomy was required in 6 patients. Both antegrade (n=4) and retrograde (n=2) methods of brain revascularization were used. RESULTS The rate of detection of tandem lesion in patients with ischemic stroke who underwent endovascular treatment was 5.4%. Technical success in restoring blood flow in the ICA basin at extra-and intra-cranial levels (mTICI 2b/3) was achieved in 7 (87.5%) patients. Intracranial hemorrhagic complications that affected the outcome of the disease were clinically significant in 25% of patients (n=2). The mortality rate was 37.5% (n=3). A satisfactory clinical result (a deficit of 0-2 mRS scores) was achieved at discharge in one of 5 surviving patients. CONCLUSION Further studies of choosing the optimal surgical tactics for tandem occlusion of ICA and MCA, taking into account its effectiveness and safety, are need.
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