急性颈动脉闭塞支架置入术后血管再闭塞补救性治疗方法——股-颈动脉转流术报道 A Rescue Therapy for Vascular Reocclusion after Carotid Artery Stenting for Acute Carotid Artery Occlusion—Femoral-Carotid Artery Bypass

Abstract

急性缺血性卒中治疗的关键在于快速恢复缺血脑组织血流，发病时间窗内可给予静脉溶栓，效果不佳则桥接血管内介入治疗。当使用常规支架取栓、抽吸取栓、球囊扩张等方法未能开通闭塞的血管时，支架置入是有效的补救方法。部分患者支架置入后可能出现血管再闭塞，如不能快速开通闭塞血管，可导致严重残疾或死亡。本文报道了1例股-颈动脉转流术补救性治疗急性颈动脉闭塞支架置入术后血管再闭塞患者的诊疗过程，为快速解决这种不常见却又非常棘手的临床情况提供思路，该术式是一种值得推广普及的手术方式。 Abstract: The key to the treatment of acute ischemic stroke is to quickly restore the blood flow of ischemic brain tissue, intravenous thrombolysis therapy can be given in the time window, and bridging endovascular interventional therapy if the effect is not good. Stent implantation is an effective remedy when conventional methods such as stent thrombectomy, aspiration thrombectomy and balloon dilatation fail to open the vessel. However, in some cases, vascular reocclusion may occur after stent implantation. If the occlusive vessel can not be revascularization quickly, the patient’s outcome can only be severe disability or death. This paper reports the diagnosis and treatment of a patient with vascular reocclusion after carotid artery stenting for acute carotid artery occlusion by femoral-carotid artery bypass. Femoral-carotid artery bypass is a new and effective surgical method, which can quickly solve this unusual but very difficult situation and is worth popularizing.

Keywords

• 急性缺血性卒中
• 颈动脉支架置入术
• 颈动脉再闭塞
• 股-颈动脉转流术
• 补救性治疗
• acute ischemic stroke
• carotid artery stenting
• carotid artery reocclusion
• femoral-carotid artery bypass
• rescue therapy