首页> 外文期刊>AJNR. American journal of neuroradiology >Intracranial stent placement for recanalization of acute cerebrovascular occlusion in 32 patients.
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Intracranial stent placement for recanalization of acute cerebrovascular occlusion in 32 patients.

机译:颅内支架置入术治疗32例急性脑血管阻塞再通。

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BACKGROUND AND PURPOSE: Stents have been reported as an option for improvement of the recanalization rate in AIS. The authors have also used intracranial stents in failed cases of IAT with pharmacologic and mechanical methods since 2004. We retrospectively reviewed our cases of intracranial stent use for IAT of AIS for recanalization and as a rescue procedure for iatrogenic intracranial vascular dissection during IAT. MATERIALS AND METHODS: Thirty-two patients, who were diagnosed with AIS, were treated with intracranial stents (28 balloon-mounted and 7 self-expandable stents) at our neurovascular center between April 2004 and December 2008. The stent use for all 32 patients was the final attempt to recanalize occluded vessels after various trials of pharmacologic or mechanical thrombolysis or to treat iatrogenic vascular dissection. RESULTS: Among the 32 patients, immediate poststenting angiographic recanalization was achieved in 100% with TIMI/TICI 2 (15 of 32 lesions, 46.9%) or TIMI/TICI 3 (17 of 32 lesions, 53.1%). However, complication rates were also high. Major symptomatic intracerebral hemorrhage (1 case of procedural symptomatic hemorrhage and 3 cases of delayed symptomatic hemorrhage) occurred in 4 (12.5%); intracranial vascular dissection, in 4 (12.5%); extracranial vascular dissection, in 3 (9.4%); immediate IST, in 4 (12.5%); subacute (within 1 week) IST, in 2; late (>1 week) IST, in 1, and 1 case of in-stent restenosis occurred twice (at 5 and 17 months). CONCLUSIONS: Intracranial stent placement for AIS management has an excellent recanalization rate. However, it is associated with high complication risks as our series showed. We believe that the decision to treat AIS with intracranial stent placement should be made after careful consideration of potential benefits and risks.
机译:背景与目的:支架已被报道作为改善AIS再通率的一种选择。自2004年以来,作者还使用药理学和机械方法在IAT失败的病例中使用了颅内支架。材料与方法:2004年4月至2008年12月之间,对32例诊断为AIS的患者在我们的神经血管中心进行了颅内支架治疗(28个球囊固定支架和7个自膨胀支架)。全部32例患者均使用支架经过各种药理或机械溶栓试验或治疗医源性血管夹层手术后,这是对闭塞血管进行再通的最终尝试。结果:32例患者中,100%的TIMI / TICI 2(32个病变中的15个,占46.9%)或TIMI / TICI 3(32个病变中的17个,53.1%)实现了即时支架后血管造影再通。但是,并发症发生率也很高。严重的症状性脑出血(程序性症状性出血1例,迟发性症状性出血3例)发生4例(12.5%);颅内血管解剖,占4(12.5%);颅外血管解剖,占3(9.4%);直接IST,占4(12.5%); 2次亚急性(1周内)IST; IST(> 1周)晚期(1周)和1例支架内再狭窄发生两次(分别在5和17个月时)。结论:用于AIS处理的颅内支架置入术具有良好的再通率。但是,正如我们的系列所示,它与高并发症风险相关。我们认为,应在仔细考虑潜在的益处和风险后,再决定采用颅内支架置入治疗AIS。

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