亚急性或慢性症状性眼段颈内动脉闭塞的血管内再通。

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-02-01 DOI:10.1016/j.ejrad.2024.111885

Ling-Xiao Feng, Huili Gao, Jinlong Zhang, Jianjun Gu, Yongfeng Wang, Tianxiao Li, Bulang Gao

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Endovascular recanalization was performed in all patients, and recanalization was successful in 130 (96.3 %). Five patients (3.7 %) were not recanalized because of intraprocedural complications. Periprocedural complications occurred in 16 patients, resulting in a total complication rate of 11.9 %. The mRS (modified Rankin Scale score) was 1.45 ± 0.03 after recanalization, significantly (P < 0.001) better than that (2.25 ± 0.12) before recanalization. The NIHSS (National Institute of Health Stroke Scale) was 11.91 ± 0.67, significantly (P < 0.0001) better than that (18.45 ± 1.33) before recanalization. Eighty-nine (65.9 %) patients underwent angiography at follow-up 6–86 (mean 48) months after recanalization, which demonstrated good prognosis in 72 (80.9 %) patients and poor prognosis in the other 17 (19.1 %) with instent restenosis > 50 %. 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引用次数: 0

摘要

目的：探讨亚急性或慢性颈内动脉阻塞眼段血管内再通术的安全性、疗效及影响预后的危险因素。材料与方法：回顾性分析135例亚急性或慢性ICA眼段闭塞患者行血管内再通术的临床、影像学及随访资料。结果：135例ICA眼段闭塞患者中，高血压72例（53.3%），糖尿病44例（32.6%），冠心病12例（8.9%），吸烟51例（37.8%），酗酒38例（28.1%）。所有患者均行血管内再通术，130例（96.3%）患者血管内再通成功。5例（3.7%）患者因术中并发症未能再通。16例患者出现围手术期并发症，总并发症发生率为11.9%。再通后mRS（改良Rankin量表评分）为1.45±0.03，差异有统计学意义（P < 50%）。再通6 ~ 38个月（平均27个月）后电话随访46例（34.1%），预后良好38例（82.6%），预后不良8例（17.4%）。总体而言，110例预后良好（81.5%），25例预后不良（18.5%）。在血管造影随访中，9例（10.1%）患者出现了50%的再狭窄。单因素分析显示，年龄（OR = 1.82）、高血压（OR = 2.38）、糖尿病（OR = 1.84）、酗酒（OR = 1.49）是影响血管内动脉再通预后的独立危险因素。(P)结论：亚急性或慢性颈内动脉眼段闭塞可通过血管内技术安全有效地再通，高血压和糖尿病是影响血管内再通预后的独立危险因素。

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Endovascular recanalization of subacute or chronic symptomatic occlusion of the internal carotid artery ophthalmic segment

Objective

To investigate the safety and effect of endovascular recanalization for subacute or chronic occlusion of the internal carotid artery (ICA) ophthalmic segment and risk factors for the prognosis.

Materials and methods

135 patients with subacute or chronic occlusion of the ICA ophthalmic segment were retrospectively enrolled to undergo endovascular recanalization, with the clinical, imaging and follow-up data being analyzed.

Results

Among 135 patients with ICA ophthalmic segment occlusion, hypertension was presented in 72 (53.3 %) patients, diabetes mellitus in 44 (32.6 %), coronary heart disease in 12 (8.9 %), smoking in 51 (37.8 %), and alcohol abuse in 38 (28.1 %). Endovascular recanalization was performed in all patients, and recanalization was successful in 130 (96.3 %). Five patients (3.7 %) were not recanalized because of intraprocedural complications. Periprocedural complications occurred in 16 patients, resulting in a total complication rate of 11.9 %. The mRS (modified Rankin Scale score) was 1.45 ± 0.03 after recanalization, significantly (P < 0.001) better than that (2.25 ± 0.12) before recanalization. The NIHSS (National Institute of Health Stroke Scale) was 11.91 ± 0.67, significantly (P < 0.0001) better than that (18.45 ± 1.33) before recanalization. Eighty-nine (65.9 %) patients underwent angiography at follow-up 6–86 (mean 48) months after recanalization, which demonstrated good prognosis in 72 (80.9 %) patients and poor prognosis in the other 17 (19.1 %) with instent restenosis > 50 %. Telephone follow-up was conducted in 46 (34.1 %) patients 6–38 (mean 27) months after recanalization, which revealed good prognosis in 38 (82.6 %) patients and poor prognosis in 8 (17.4 %). In total, good prognosis was present in 110 (81.5 %) patients while poor prognosis in 25 (18.5 %). In angiographic follow-up, instent restenosis > 50 % was present in nine (10.1 %) patients. Univariate analysis showed age (OR = 1.82), hypertension (OR = 2.38), diabetes mellitus (OR = 1.84), and alcohol abuse (OR = 1.49) were significant (P < 0.05) risk factors, whereas multivariate analysis demonstrated that only hypertension (OR = 1.54) and diabetes mellitus (OR = 2.67) were significant (P < 0.05) independent risk factors to affect the prognosis of recanalization.

Conclusion

Subacute or chronic occlusion of the internal carotid artery ophthalmic segment can be safely and efficiently recanalized using endovascular skills, and hypertension and diabetes mellitus are the independent risk factors for the prognosis of endovascular recanalization.

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来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.