ABSTRACT
Objective:To investigate the clinical efficacy of mechanical solitaire AB stents thrombectomy combined with intra-arterial thrombolysis in the treatment of patient with acute ischemic stroke.Methods:Fifteen patients with acute ischemic stroke admitted into our hospital from August 2014 to August 2016 were treated with mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis.The National Institutes of Health Stroke Scale score (NIHSS) of all patients were evaluated before and after treatment to compare the clinical efficacy.The prognosis ofpatients between two groups were compared via evaluating modified Rankin score (mRS)and gelasijia coma score (GCS).Results:After mechanical thrombectomy with solitaire AB stents plus intra-arterial thrombolysis treatment,14 patients achieved complete or part recanalization,and 1 patient was terminated treatment due to vital signs instability,and the rate ofrecanalization was 93.3％.The NIHSS score of patients before treatment was 12.93± 4.25,which was much higher than that after treatment (4.33± 1.45,P＜0.05).After follow-up by 3 months,the good mRS scores were obtained in all 18 patients,including 2 patients with mRS score of 2,5 patients with 1,and 8 patients with 0.Additionally,there was no patient with re-obstruction during follow-up period.Conclusion:Mechanical thrombectomy with solitaire AB stents combined with intra-arterial thrombolysis had a good capability and safety in the treatment of patients with acute ischemic stroke.
ABSTRACT
Objective To evaluate the safety and efficacy of endovascular embolization in treating ophthalmic segment aneurysms of internal carotid. Methods During the period from July 2008 to August 2013, a total of 23 patients with ophthalmic segment aneurysms of internal carotid were admitted to authors’ hospital to receive endovascular embolization. According to Hunt-Hess classification, grade I lesion was seen in 11 cases, grade Ⅱ in 10 cases and grade Ⅲ in 2 cases. The aneurysm diameter ranged from 2.2 mm to 19.9 mm, with a mean diameter of 5.7 mm. After the treatment follow-up examinations with DSA, MRA and modified Rankin scale were conducted to evaluate the therapeutic results. Results A total of 27 ophthalmic segment aneurysms were detected in 23 patients. Endovascular embolization was performed with guglielmi detachable coils (n = 15) or solitaire AB stent-assisted coil (n = 12). The therapeutic results immediately after the embolization were graded by Raymond classification. Complete obliteration (Grade I) was obtained in 22 aneurysms, residual neck (grade Ⅱ) in 4 aneurysms and residual aneurysm (grade Ⅲ) in one aneurysm. Procedure-related complications occurred in 3 patients, including thrombosis in the aneurysm neck (n=1), tail of the coil protruding into the stent (n=1) and transient blindness (n=1). Eighteen patients were followed up for 2 - 62 months. Follow- up examinations with angiography showed that complete embolization of the aneurysm was obtained in 15 cases (84%) and subtotal embolization of the aneurysm was seen in 3 cases (16%). In one patient who had bilateral aneurysms, the aneurysm on the untreated side was enlarged with increasing time. During the follow-up period, 18 patients had a modified Rankin score of 0 -1, and all these patients had stable clinical condition with no newly-developed neurological dysfunction or re-bleeding. Conclusion For the treatment of ophthalmic segment aneurysms of internal carotid, endovascular embolization is minimally-invasive, safe and effective, although its long-term effect and safety need to be further studied.