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Endovascular Management of Acute Proximal Internal Carotid Artery Occlusion: the JHN Experience

机译:急性近端颈内动脉闭塞的血管内治疗:JHN经验

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摘要

Stroke is a major cause of serious, long-term disability and the third leading cause of death, accounting for one in every 18 deaths in the United States. Approximately 800,000 strokes occur in the United States each year, leading to an estimated cost of 74 billion dollars in 2010. The severity and prognosis of patients with an acute internal carotid artery (ICA) occlusion is extremely poor. Studies have shown that 16-55% of patients will die from complications related to the infarction, 40-69% will be left with a profound deficit, and only 2-12% will make a reasonable recovery2. In young patients, internal carotid artery dissections presenting as an acute occlusion or thrombotic clot are responsible for approximately 14-20% of ischemic strokes.1 Results from trials utilizing emergent open surgical carotid recanalization or IVtPA have not been encouraging2,3. Recently, there have been small case reports of endovascular stent-assisted thrombolysis as a treatment option for patients with carotid occlusions and near occlusions.4-8
机译:中风是严重的长期残疾的主要原因,也是第三大死亡原因,占美国每18例死亡中的一个。在美国,每年大约发生80万例中风,2010年估计花费740亿美元。患有急性颈内动脉(ICA)闭塞的患者的严重程度和预后极差。研究表明,有16-55%的患者会死于与梗塞有关的并发症,40-69%的患者会出现严重的赤字,只有2-12%的患者会得到合理的康复2。在年轻患者中,表现为急性阻塞或血栓凝块的颈内动脉夹层约占缺血性卒中的14-20%。1利用紧急开放式颈动脉再通或IVtPA进行的试验结果令人鼓舞2,3。最近,有小病例报道了血管内支架辅助溶栓术作为颈动脉闭塞和近闭塞患者的治疗选择。4-8

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