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首页> 外文期刊>Vascular and endovascular surgery >Acute Stroke Treatment by Surgical Recanalization of Extracranial Internal Carotid Artery Occlusion: A Single Center Experience
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Acute Stroke Treatment by Surgical Recanalization of Extracranial Internal Carotid Artery Occlusion: A Single Center Experience

机译：通过外颅内颈动脉闭塞的手术重新化急性卒中治疗：单一中心经验

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摘要

Ischemic stroke due to an acute occlusion of the extracranial internal carotid artery (eICA) is associated with high morbidity and mortality. The best treatment option remains unclear. This study aims to increase the available therapeutic experience documented for surgical recanalization of acute eICA occlusions. We retrospectively reviewed all hospital records of the University Hospital Jena between 2006 and 2018 to identified patients with acute ischemic stroke due to an occlusion of the eICA who underwent emergent surgical recanalization. We analyzed clinical data, surgical reports, imaging data, and outpatient records. The primary outcome parameter was the modified Rankin Scale (mRS) at 3 months. During the survey, 12 patients (mean age: 62.3 +/- 10.8 years; range: 35-87) underwent emergent surgical recanalization for an acutely symptomatic eICA occlusion. All patients presented with neurological deficits with a mean National Institutes of Health Stroke Scale score at admission of 15.0 +/- 5.1 (range 2-23). Patients were selected for surgery mainly due to the extent of the perfusion mismatch, while stroke severity and age were also considered. The median time from symptom onset to surgery was 309 +/- 122 minutes (range 112-650 minutes). Complete recanalization was obtained in all 12 patients. No patient deteriorated postoperatively, no intracranial hemorrhage was observed, and no patient died in the following 3 months. Favorable outcomes (mRS: 0-2) after 3 months were achieved in 7 of 12 patients. The current study adds support to previous findings that the surgical recanalization of acute eICA occlusions is a possible and safe treatment option. However, a critical patient selection based on mismatch size in perfusion imaging is crucially important for successful treatment.
机译：由于颅内内颈动脉（EICA）的急性闭塞导致缺血性脑卒中与高发病率和死亡率有关。最好的治疗选项仍然不清楚。本研究旨在增加急性EICA闭塞的手术重新化的可用治疗经验。我们回顾性地审查了2006年至2018年在2006年至2018年至2018年至2018年在2006年至2018年间急性缺血性卒中患者审查了急性缺血性脑卒中的患者，这是由于EICS的闭塞，他们接受了外科手术重新化。我们分析了临床数据，外科报告，成像数据和门诊记录。主要结果参数是3个月的改进的Rankin规模（MRS）。在调查期间，12名患者（平均年龄：62.3 +/- 10.8岁;范围：35-87）急性症状EICA闭塞的急诊手术重新化。所有患者患有神经缺陷的患者，均具有平均国家健康卒中量表评分15.0 +/- 5.1（范围2-23）。患者选择外科，主要是由于灌注失配，而中风严重程度和年龄也被考虑。从症状发作到手术的中位时间为309 +/- 122分钟（范围112-650分钟）。在所有12名患者中获得了完全重新化。术后没有患者恶化，未观察到颅内出血，并且在以下3个月内没有患者死亡。在12名患者的7名患者中实现了3个月后有利的结果（MRS：0-2）。目前的研究增加了对先前发现的支持，即急性EICA闭塞的手术重新化是一种可能的和安全的治疗选择。然而，基于灌注成像中错配大小的关键患者选择对于成功治疗至关重要。

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