ENDOVASCULAR TECHNIQUES FOR BLOOD FLOW RESTORATION IN CASE OF THROMBOSIS OF INTERNAL CAROTID ARTERY IN PATIENTS WITH ACUTE ISCHEMIC STROKE
Abstract
Objective: To present the results of intraarterial methods applying for blood flow restoration (recanalization) in case of thrombosis of internal carotid artery (ICA) in patients with acute ischemic stroke (ACI) Materials and Methods: During period from December 2006 till February 2014, 11 patients (8 men, 3 women), average aged 62, with ACI symptoms and occlusion of ICA were treated within 6-hour therapeutic window using various methods of intraarterial recanalization. The average severity of neurological deficit at admission was 18 scores by NIHSS. Two patients were treated with selective infusion of the rt-PA (Actilyse «Boehringer Ingelheim») thrombolytic agent and aspiration of thrombotic masses, while ICA stenting was performed in 7 patients. Stent-assisting devices with the Solitaire stent (EV3) were used in 4 patients. Results: The successful recanalization of (TICI 2b-3) ICA was achieved in 45,7%. The frequency of symptomatic hemorrhagic transformations in patients with ICA occlusion was 18,3% while the fatal brain edema was observed in one case. The good clinical (neurological impairment — 0-2 scores by mRs) outcome was observed in 2 patients, mortality was 27,2% (3 patient died). Conclusions: The accurate selection of patients with evaluation of the volume of brain ischemic damage is necessary for safe and effective intraarterial reperfusion in case of acute ICA thrombosis. The mechanical devices of revascularization should only be used in case of acute ICA thrombosis. The type of ICA occlusion and degree of collateral blood flow must be taking into account during selection of surgical intervention type
About the Authors
M. Yu. Volodyukhin
ГАУЗ «Межрегиональный клинико-диагностический центр».
Russian Federation
Russian Federation
D. R. Khasanova
ГАУЗ «Межрегиональный клинико-диагностический центр».
Russian Federation
Russian Federation
T. V. Demin
ГАУЗ «Межрегиональный клинико-диагностический центр».
Russian Federation
Russian Federation
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Review
For citations:
Volodyukhin M.Yu., Khasanova D.R., Demin T.V. ENDOVASCULAR TECHNIQUES FOR BLOOD FLOW RESTORATION IN CASE OF THROMBOSIS OF INTERNAL CAROTID ARTERY IN PATIENTS WITH ACUTE ISCHEMIC STROKE. Russian journal of neurosurgery. 2016;(1):28-34. (In Russ.)
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