多模式血管再通术联合高压氧治疗急性颈内动脉末端闭塞疗效观察

摘要

Objective To investigate the effects of multi-mode revascularization combined with hyperbaric oxygen (HBO) in the treatment of acute internal carotid artery occlusion.Methods One mid-aged female patient was admitted into hospital 1 hour after sudden onset of unconsciousness.Past medical history included rheumatic heart disease and atrial fibrillation.Digital subtraction angiography (DSA) showed occlusion at the distal end of internal carotid artery.With the knowledge and consent of the dependants,endovascular intervention treatment was performed and HBO therapy was supplemented after surgery.Results Due to the location,size and complexity of shapes of thrombi,re-canalization was not successful after trying in sequence stent thrombectomy,balloon catheter disruption of thrombi and contact arterial thrombolysis.Finally,the occluded vessel was re-canalized successfully by the catheter aspiration technique,and the prognosis of the patient improved significantly.Conclusions This case suggests that the combined use of multi-mode endovascular interventional technology is an effective method for re-canalizing occluded vessels.Supplemented HBO therapy after surgery is beneficial to the improvement of prognosis.%目的 探讨多模式血管再通术联合高压氧治疗急性颈内动脉末端闭塞的疗效.方法 1例中年女性患者,因突发神志不清1h入院,有风湿性心脏病、房颤病史,脑血管造影提示颈内动脉末端闭塞,经知情同意后行血管内介入治疗,术后联合高压氧治疗.结果 由于栓塞的位置、大小及形态复杂性,先后尝试支架取栓、球囊碎栓、接触性动脉溶栓等手术办法均未再通闭塞血管,最终采取导管抽吸血栓技术将闭塞血管开通,患者预后明显改善.结论 本病例提示多模式血管内介入技术的联合应用是再通闭塞血管的有效手段,术后联合高压氧治疗有助于改善患者预后.