关键词: 】 颅内; 动脉闭塞; 经皮腔内血管成形术; 出血性转化; 小径球囊; 尿激酶

Abstract: Objective To discuss the prevention effects of partial recanalization mainly by percutaneous transluminal angioplasty(PTA) with smaller diameter balloon or combining with low dose of Urokinase(UK) on hemorrhagic transformation after acute occlusion of anterior intracranial arteries.Methods We treated 38 cases with acute occlusion of anterior intracranial arteries by endovascular therapy, 16 cases by routine UK with microcatheter and microwire(control group), 22 cases by PTA with smaller diameter balloon or with low dose of UK(PTA group). We observed the frequency of recanalized hemorrhagic transformation and the prognosis in two groups.Results Recanalizing time was signifcantly shorter in PTA group than in control group(18.3±8.1 min vs. 63.9±18.9 min, P<0.01). Residue stenosis rate of less than 50% were 75.0%(12/16) for control group, 22.7%(5/22) for PTA group and there was signifcantly different between them(P<0.01). Total 7 of 38 patients suffered from hemorrhagic transformation, in which 4 cases occured in control group, 3 cases in PTA group, and 4 (3 in control group,1 in PTA group)of them needed surgery treatment with remaining severe dysfunction, but no one died because of hemorrhagic transformation.Conclusion Within therapy time window, partial recanalization mainly by PTA using smaller diameter balloon has active prophylactic effects on hemorrhagic transformation after acute occlusion of anterior intracranial arteries. It can largely elevate recanalizing rate and shorten recanalizing time, which is a good base for the following stent.

Key words: Intracranial; artery occlusion; Percutaneous transluminal angioplasty; Hemorrhagic transformation; Small-diameter balloon; Urokinase