| 陈飞雄,鲍娟,张贤,曹毅,景睿,胡佳怡.血管内治疗用于颈内动脉夹层致急性缺血性脑卒中[J].中国介入影像与治疗学,2025,22(12):753-758 |
| 血管内治疗用于颈内动脉夹层致急性缺血性脑卒中 |
| Endovascular therapy for acute ischemic stroke caused by internal carotid artery dissection |
| 投稿时间：2025-10-13 修订日期：2025-11-28 |
| DOI：10.13929/j.issn.1672-8475.2025.12.001 |
| 中文关键词: 颈内动脉夹层 缺血性脑卒中 血管内治疗 |
| 英文关键词:carotid artery,internal,dissection ischemic stroke endovascular treatment |
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| 中文摘要: |
| 目的 观察血管内治疗用于颈内动脉夹层致急性缺血性脑卒中的价值。方法 回顾性纳入21例接受血管内治疗的颈内动脉夹层致急性缺血性脑卒中，包括12例单纯颈内动脉颅外段病变和9例串联病变，记录临床资料，评估血管内治疗的有效性和安全性。结果 21例中，18例于入院即刻接受急诊治疗， 3例于症状加重后接受补救性治疗；11例直接接受血管内治疗，10例接受静脉溶栓（IVT）桥接血管内治疗；治疗后即刻改良脑梗死溶栓（mTICI）2b级2例、3级19例，均成功实现血管再通。治疗中与治疗后6例串联病变出现不同程度并发症。治疗后90天，16例（16/21，76.19%）改良Rankin量表（mRS）评分≤2 ，包括12例单纯颈内动脉颅外段病变及4例串联病变；5例（5/21，23.81%）评分＞2分，均为串联病变。入院时、治疗前及出院时美国国立卫生研究院卒中量表（NIHSS）评分分别为8.57±7.14、9.67±6.26及5.24±5.17；出院时NIHSS评分显著低于入院时及治疗前（P均＜0.05）。结论 血管内治疗用于颈内动脉夹层致急性缺血性脑卒中有效且安全。 |
| 英文摘要: |
| Objective To observe the value of endovascular therapy for acute ischemic stroke（AIS） caused by internal carotid artery dissection. Methods Totally 21 patients with AIS caused by internal carotid artery dissection who underwent endovascular therapy were retrospectively enrolled， including 12 cases of simple lesion in extracranial segment and 9 cases of tandem lesions of internal carotid artery. Clinical data were recorded， and the efficacy and safety of endovascular therapy were analyzed. Results Among 21 cases， 18 cases received immediate emergency treatment upon admission， while 3 cases received remedial endovascular therapy after worsening symptoms， including 11 cases underwent direct endovascular treatment and 10 cases underwent intravenous thrombolysis （IVT） bridging endovascular therapy. Immediately after treatment， the modified thrombolysis in cerebral infarction （mTICI） was 2b grade in 2 cases and 3 grade in 19 cases， and vascular recanalization was successfully achieved in all 21 cases. During and after treatment， varying degrees of complications occurred in 6 cases with tandem lesions. Ninety days after treatment， the modified Rankin scale （mRS） was ≤2 in 16 cases （16/21， 76.19%）， including 12 cases of simple lesion in extracranial segment of internal carotid artery and 4 cases of tandem lesions， while was ＞2 in 5 cases （5/21， 23.81%） with tandem lesions. National Institute of Health stroke scale （NIHSS） score at admission， pre-treatment and discharge was 8.57±7.14， 9.67±6.26 and 5.24±5.17， respectively， at discharge was significantly lower than at admission and pre-treatment （both P＜0.05）. Conclusion Endovascular therapy was effective and safe for AIS caused by internal carotid artery dissection. |
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