非瓣膜性心房颤动所致心源性栓塞机械取栓术后复发的预防——3例病例报道并文献复习

doi:10.3969/j.issn.1673-5765.2025.01.015

摘要/Abstract

摘要： 非瓣膜性心房颤动继发的缺血性卒中占所有急性缺血性卒中的20%～30%，且此类卒中多有高负荷量血栓、较大脑血管堵塞及较差的侧支代偿，因此与其他缺血性卒中相比，具有症状更重、预后更差、死亡率偏高的特点。此类卒中患者，即使成功取栓血管再通，术后短期内也存在较高的复发风险。本文以3例非瓣膜性心房颤动性卒中患者为例，介绍其机械取栓后卒中复发并再次取栓的治疗过程，结合相关文献，分析非瓣膜性心房颤动导致心源性栓塞的特点，总结此类卒中患者机械取栓术后卒中复发的预防措施。

关键词: 非瓣膜性心房颤动; 缺血性卒中; 机械取栓; 复发; 抗凝

Abstract: Ischemic strokes secondary to nonvalvular atrial fibrillation account for 20%-30% of all acute ischemic strokes, and these strokes often have high-load thrombosis, larger cerebrovascular blockages, and poor collateral compensation. Therefore, compared with other types of ischemic strokes, they are characterized by more severe symptoms, worse prognosis, and higher mortality. Patients with such strokes, even if successful revascularization is achieved through thrombectomy, have a high risk of recurrence in the short term after surgery. This article takes three stroke patients with nonvalvular atrial fibrillation as examples to describe the process of stroke recurrence and re-thrombectomy after mechanical thrombectomy. By combining with relevant literature, it analyzes the characteristics of cardiogenic embolism caused by nonvalvular atrial fibrillation and summarizes the preventive measures for the recurrence of patients with such strokes after mechanical thrombectomy.

Key words: Nonvalvular atrial fibrillation; Ischemic stroke; Mechanical thrombectomy; Recurrence; Anticoagulation

中图分类号:

张海兵, 夏卫东, 王奉淼, 李文帅, 李庆民, 张信芳, 张全忠. 非瓣膜性心房颤动所致心源性栓塞机械取栓术后复发的预防——3例病例报道并文献复习[J]. 中国卒中杂志, 2025, 20(1): 119-125.

ZHANG Haibing, XIA Weidong, WANG Fengmiao, LI Wenshuai, LI Qingmin, ZHANG Xinfang, ZHANG Quanzhong. Prevention of Recurrence after Mechanical Thrombectomy for Cardiogenic Embolism Induced by Nonvalvular Atrial Fibrillation: A Report of Three Cases and Literature Review[J]. Chinese Journal of Stroke, 2025, 20(1): 119-125.

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