关键词: 卒中; 大脑中动脉; 支架; 介入治疗

Abstract:

Objective To explore optimization of treatment method of intra-arterial thrombectomy and its clinical effects in acute middle cerebral artery occlusion. Methods Patients with acute middle cerebral artery (MCA) occlusion who underwent thrombectomy by using Solitaire stent were taken as study subjects. The involved lesions characteristics, endovascular treatment methods, recanalization status and post-surgery improvement of neurological function were analyzed retrospectively. Results A total of 77 patients with acute middle cerebral artery (MCA) occlusion who underwent thrombectomy by using Solitaire stent in Dept. of Cerebral Vascular Intervention, Zhongshan People’s Hospital during Jan. 2014 and August, 2016 were enrolled into study consecutively. The occluded arteries included M1 segment of MCA (M1-MCA, Right n =27, Left n =25), inferior division of MCA (MCA-ID, n =10), and superior division of MCA (MCA-SD, n =15). Residual luminal stenosis after thrombectomy was found in 26 cases, among which stent implantation (n =17), balloon dilatation (n =6) or regional thrombolysis (n =3) were carried out ultimately. Successful recanalization was achieved in all patients (n =77), in which 48 patients showed good clinical outcome (62.34% ) at 90 d after surgery with modified Rankin Scale (mRS) score <2. Postoperative intracranial hemorrhage occurred in 6 patients (7.79%), and decompressive craniectomy were carried out in 5 patients (6.49%) with acute cerebral swelling . Conclusion This study suggests that thrombectomy by using Solitaire stent can achieve satisfactory recanalization rate in patients with MCA occlusion and good prognosis at month 3.

Key words: Stroke; Middle cerebral artery; Stent; Interventional therapy