[1]张 文,孙红光,刘振生,等.反常脑栓塞的临床诊断及血管内治疗[J].医学信息,2018,31(18):179-181,187.[doi:10.3969/j.issn.1006-1959.2018.18.059]
 ZHANG Wen,SUN Hong-guang,LIU Zhen-sheng,et al.Clinical Diagnosis and Endovascular Treatment of Abnormal Cerebral Embolism[J].Journal of Medical Information,2018,31(18):179-181,187.[doi:10.3969/j.issn.1006-1959.2018.18.059]
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反常脑栓塞的临床诊断及血管内治疗()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
31卷
期数:
2018年18期
页码:
179-181,187
栏目:
出版日期:
2018-09-15

文章信息/Info

Title:
Clinical Diagnosis and Endovascular Treatment of Abnormal Cerebral Embolism
文章编号:
1006-1959(2018)18-0179-04
作者:
张 文1孙红光1刘振生2张新江3
扬州大学附属医院超声科1,介入放射科2,神经科3,江苏 扬州 225001
Author(s):
ZHANG Wen1SUN Hong-guang1LIU Zhen-sheng2ZHANG Xin-jiang3
Department of Ultrasound1,Department of Interventional Radiology2,Department of Neurology3,Affiliated Hospital of Yangzhou University,Yangzhou 225001,Jiangsu,China
关键词:
卒中卵圆孔未闭反常性栓塞超声心动图
Keywords:
Key words:StrokePatent foramen ovaleAbnormal embolismEchocardiography
分类号:
R743
DOI:
10.3969/j.issn.1006-1959.2018.18.059
文献标志码:
B
摘要:
目的 评价反常脑栓塞的血管内治疗疗效、临床诊断方法及卒中二级预防。方法 回顾分析2008年1月~2017年5月在扬州大学附属医院经血管内治疗的重症隐源性卒中患者11例的影像及临床资料。术后1周内对所有CS患者行经食管超声心动图检查,反常性栓塞风险量表评分,术后3个月采用改良Rankin评分(mRs)评估患者的临床预后。结果 接受血管内治疗的重症CS患者共11例,经食管超声心动图检查明确卵圆孔未闭者6 例,其中合并房间隔瘤2例。6例反常栓塞患者经血管内治疗后血管再通率(TICI 2b/3级)100.00%,RoPE评分均>6分,平均(7.81±1.20)分,预后良好(mRS≤2分)者4例(66.67%),3例患者于术后6个月内行卵圆孔介入封堵治疗。结论 PFO致反常脑栓塞血管内治疗再通率高,临床预后相对好,结合经食管超声心动图检查利于明确病因及脑卒中的二级预防。
Abstract:
Abstract:Objective To evaluate the efficacy, clinical diagnosis and secondary prevention of stroke in patients with abnormal cerebral embolism.Methods The imaging and clinical data of 11 patients with severe cryptogenic stroke who underwent endovascular treatment at the Affiliated Hospital of Yangzhou University from January 2008 to May 2017 were retrospectively analyzed.All patients with CS underwent transesophageal echocardiography within 1 week after surgery,and the abnormal embolism risk scale was scored.The clinical outcome was assessed by modified Rankin scores(mRs)3 months after surgery.Results A total of 11 patients with severe CS who underwent endovascular treatment were treated with esophageal echocardiography and 6 patients with patent foramen ovale, including 2 patients with atrial septal tumor.6 patients with abnormal embolization had an vascular recanalization rate(TICI 2b/3)of 100.00%,a RoPE score of >6,an average of(7.81±1.20),4 patients(66.67%)had a good prognosis(mRS≤2 points),and 3 patients underwent interventional closure of the foramen ovale within 6 months after surgery.Conclusion PFO-induced abnormal cerebral embolization has a high recanalization rate and a relatively good clinical prognosis.Combined with transesophageal echocardiography, it is helpful to identify the secondary causes of etiology and stroke.

参考文献/References:


[1]Melkumova E,Thaler DE.Cryptogenic Stroke and Patent Foramen Ovale Risk Assessment[J].Interv Cardiol Clin,2017,6(4):487-493.
[2]Singh HS,Katchi F,Naidu SS.PFO Closure for Cryptogenic Stroke:A Review and Clinical Treatment Algorithm[J].Cardiol Rev,2017,25(4):147-157.
[3]管强,聂志余.反常栓塞与隐源性卒中[J].中华内科杂志,2014,53(2):149-150.
[4]Saver JL.Cryptogenic Stroke[J].New England Journal of Medicine,2016,374(21):2065.
[5]刘振生,王苇,张新江,等.球囊碎栓辅助动脉溶栓治疗急性大脑中动脉闭塞[J].介入放射学杂志,2009,18(2):84-86.
[6]刘振生,孙勇,匡雄伟,等.部分回收支架夹栓在急性脑梗死Solitaire支架取栓术中的初步应用[J].中华放射学杂志,2017,51(7):538-540.
[7]朱永胜,孟欣,江文,等.中青年隐源性缺血性脑卒中与卵圆孔未闭的关系[J].中华超声影像学杂志,2014,23(7):568-572.
[8]郑华光,王伊龙,陈启东,等.反常性栓塞风险量表在合并卵圆孔未闭的隐源性卒中或短暂性脑缺血发作患者中的应用[J].中国卒中杂志,2014,9(8):654-662.
[9]Meier B,Frank B,Wahl A,et al.Secondary stroke prevention: patent foramen ovale,aortic plaque,and carotid stenosis[J].Eur Heart J,2012,33(6):705-713.
[10]Piechowski-Jozwiak B,Bogousslavsky J.Stroke and patent foramen ovale in young individuals[J].Eur Neurol,2013,69(2):108-117.
[11]Thaler D.Patent foramen ovale in older patients with cryptogenic stroke or transient ischaemic attack[J].Lancet Neurol,2018,17(7):573-574.
[12]Meier B,Kalesan B,Mattle HP,et al.Percutaneous closure of patent foramen ovale in cryptogenic embolism[J].N Engl J Med,2013,368(12):1083-1091.
[13]Carroll JD,Saver JL,Thaler DE,et al.Closure of patent foramen ovale versus medical therapy after cryptogenic stroke[J].N Engl J Med,2013,368(12):1092-1100.

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更新日期/Last Update: 2018-09-15