Đánh giá kết quả ban đầu can thiệp nong bóng điều trị hẹp động mạch nội sọ trên bệnh nhân nhồi máu não cấp=Evaluation the initial results of balloon angioplasty in the treatment of intracranial artery stenosis patients with acute ischemic stroke

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Thanh Lưu Đào, Ngọc Hòa Nguyễn, Thanh Long Nguyễn

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.126-133

Bộ sưu tập: Metadata

ID: 242215

Thêm vào giỏ

Đánh giá kết quả can thiệp nong bóng đơn thuần trong điều trị hẹp động mạch nội sọ trên bệnh nhân nhồi máu não cấp. Đối tượng và phương pháp: Nghiên cứu mô tả cắt ngang, hồi cứu và tiến cứu, theo dõi dọc, so sánh trước và sau điều trị, không đối chứng trên 9 bệnh nhân nhồi máu não cấp có hẹp động mạch nội sọ được can thiệp nong bóng đơn thuần tại Trung tâm Đột Quỵ, Bệnh viện Hữu Nghị Đa Khoa Nghệ An từ tháng 06/2022 đến tháng 09/2023. Kết quả: Tỉ lệ thành công 100 %, tái thông tốt: TICI 2b-3 (77,78%). Hẹp động mạch nội sọ sau can thiệp nong bóng trung bình (42,77±21,08 %), cải thiện rõ so với trước can thiệp là (89,33 ± 6,14 %) (p <
0,001). Không có trường hợp nào gặp biến chứng trong can thiệp như thủng/rách mạch hay bị lóc tách lòng mạch, chuyển dạng chảy máu, dị ứng thuốc cản quang hay tụ máu/có giả phình vị trí chọc động mạch đùi. Sau 03 tháng, tình trạng phục hồi lâm sàng của bệnh nhân theo thang điểm mRS có 55,6 % phục hồi tốt khả năng sinh hoạt độc lập và 44,4 % bệnh nhân có phụ thuộc chức năng một phần hoặc hoàn toàn, không có bệnh nhân tử vong. Kết luận: Điều trị can thiệp nong bóng trong hẹp động mạch nội sọ nhồi má não cấp đạt tỉ lệ thành công cao, mức độ tái thông và phục hồi tốt khá cao, thủ thuật khá an toàn với tỉ lệ biến chứng thấp.Evaluate the results of balloon angioplasty alone in treating intracranial artery stenosis patients with acute ischemic stroke. Subjects and methods: A descriptive crosssectional, retrospective, and prospective study with longitudinal follow-up, comparing pre- and post-treatment outcomes without a control group. The study 9 patients involved patients with acute ischemic stroke and intracranial artery stenosis who underwent balloon angioplasty at the Stroke Center, Nghe An General Friendship Hospital, from June 2022 to September 2023. Results: The procedure had a 100% success rate with good recanalization (TICI 2b-3) achieved in 77.78% of the cases. The mean degree of intracranial artery stenosis post-angioplasty was 42.77±21.08 %, significantly improved from the pre-angioplasty stenosis degree of 89.33±6.14 %, with a statistically significant difference (p <
0.001). No complications such as vessel perforation/rupture or dissection occurred during the procedure, and no patients experienced hemorrhagic transformation, contrast agent allergy, or hematoma/pseudoaneurysm at the femoral puncture site post-procedure. After three months, clinical recovery based on the mRs score showed that 55.6% of patients had good recovery with independent living ability, and 44.4% had partial or complete functional dependency, with no deaths reported. Conclusion: Balloon angioplasty alone for intracranial artery stenosis in patients with acute ischemic stroke achieves a high success rate, good recanalization, and recovery rates, and is relatively safe with a low complication.

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