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中华脑血管病杂志(电子版) ›› 2022, Vol. 16 ›› Issue (04) : 292 -295. doi: 10.11817/j.issn.1673-9248.2022.04.014

病例报告

经甲状颈干逆行指引开通椎动脉并基底动脉取栓术一例
李扬1, 师瑞1, 李德帅1, 张潇1, 魏东1,()   
  1. 1. 710032 西安,陕西省西京医院神经内科
  • 收稿日期:2021-10-20 出版日期:2022-08-01
  • 通信作者: 魏东
  • 基金资助:
    国家自然科学基金青年项目(81400873); 西京医院学科助推计划项目(XJZT18ML47)

Retrograde vertebral artery revascularization using thyrocervical collaterals for mechanical thrombectomy of acute basilar artery occlusion: a case report

Yang Li1, Rui Shi1, Deshuai Li1   

  • Received:2021-10-20 Published:2022-08-01
引用本文:

李扬, 师瑞, 李德帅, 张潇, 魏东. 经甲状颈干逆行指引开通椎动脉并基底动脉取栓术一例[J]. 中华脑血管病杂志(电子版), 2022, 16(04): 292-295.

Yang Li, Rui Shi, Deshuai Li. Retrograde vertebral artery revascularization using thyrocervical collaterals for mechanical thrombectomy of acute basilar artery occlusion: a case report[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2022, 16(04): 292-295.

图1 进展性脑卒中患者全脑血管数字减影图。图a示右侧颈内动脉造影未见后交通动脉开放;图b示左侧颈内动脉造影未见后交通动脉开放;图c示右侧椎动脉纤细,V1段中度狭窄(白色箭头所指);图d白色圆圈内示右侧椎动脉V4段显影浅淡;图e左侧锁骨下动脉造影见左侧椎动脉自开口处闭塞,甲状颈干分支代偿增粗致椎动脉V2段中段以远显影
图2 进展性脑卒中患者左侧椎动脉开通术中图像。图a示甲状颈干、肋颈干各分支代偿增粗致左侧椎动脉V2段中段以远显影;图b为微导管超选甲状颈干分支后造影图像;图c示SL-10微导管在Synchro2微导丝导引下顺利通过甲状颈干的分支,并逆向到达左侧椎动脉闭塞段远侧;图d白色圆圈内示Synchro2微导丝拟逆向、V-18导丝拟顺向通过左侧椎动脉闭塞段;图e示V-18导丝正向顺利通过左侧椎动脉闭塞段;图f、g示沿V-18导丝将Spider保护伞(白色箭头所指)放置于V2段上段,先后用2 mm×20 mm、3 mm×30 mm球囊扩张1次;图h示在左侧椎动脉开口处置入APOLLO球囊扩张支架(微创神通3.5 mm×18 mm)1枚
图3 脑卒中患者术中基底动脉取栓图。图a示基底动脉远端闭塞,白色圆圈内可见血栓影;图b、c示取栓术后基底动脉及各分支显影通畅
图4 支架及中间导管取出的血栓
1
Haussen DC, Dharmadhikari SS, Snelling B, et al. Posterior communicating and vertebral artery configuration and outcome in endovascular treatment of acute basilar artery occlusion [J]. J Neurointerv Surg, 2015, 7(12): 864-867.
2
Mattle HP, Arnold M, Lindsberg PJ, et al. Basilar artery occlusion [J]. Lancet Neurol, 2011, 10(11): 1002-1014.
3
Schonewille WJ, Wijman CA, Michel P, et al. Treatment and outcomes of acute basilar artery occlusion in the Basilar Artery International Cooperation Study (BASICS): a prospective registry study [J]. Lancet Neurol, 2009, 8(8): 724-730.
4
Cohen JE, Leker RR, Gomori JM, et al. Emergent revascularization of acute tandem vertebrobasilar occlusions: Endovascular approaches and technical considerations-confirming the role of vertebral artery ostium stenosis as a cause of vertebrobasilar stroke [J]. J Clin Neurosci, 2016, 34: 70-76.
5
Khilchuk AA, Agarkov MV, Vlasenko SV, et al. Successful retrograde recanalization of acute right dominant vertebral artery occlusion through the left posterior communicating artery in a patient with acute vertebrobasilar ischemic stroke [J]. Radiol Case Rep, 2018, 13(2): 475-478.
6
Hui FK, Narayanan S, Cawley CM. Posterior-to-anterior circulation access using the Penumbra Stroke System for mechanical thrombectomy of a right middle cerebral artery thrombus [J]. World Neurosurg, 2010, 73(1): 17-21.
7
Gross BA, Jadhav AP, Jankowitz BT, et al. Recanalization of tandem vertebrobasilar occlusions with contralateral vertebral occlusion or hypoplasia via either direct passage or the SHERPA technique [J]. Interv Neurol, 2020, 8(1): 13-19.
8
Morales A, Parry PV, Jadhav A, et al. A novel route of revascularization in basilar artery occlusion and review of the literature [J]. J Neurointerv Surg, 2016, 8(7): e25.
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