Combined intraarterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis
Combined intraarterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis
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DOI：
10.1007/s11239-009-0386-3
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发表时间：
2010-04-01
影响因子：
4
通讯作者：
Liu, Xinfeng
中科院分区：
文献类型：
--
作者：
Yue, Xuanye;Xi, Gangming;Liu, Xinfeng
探讨动静脉联合溶栓治疗重症脑静脉窦血栓形成的安全性和有效性。我院近3年来收治的28例脑静脉窦血栓形成患者中，6例行动静脉联合溶栓治疗。每例患者均采用球囊导管局部接触性溶栓，使血栓破裂，并在静脉窦内注入尿激酶进行溶栓。同时经颈内动脉注入尿激酶（100，000 IU/h）溶解静脉血栓。记录神经功能结局、格拉斯哥昏迷评分（GCS）、神经影像学结果和改良兰金量表评分（mRS）。在6例接受治疗的患者中，2例为男性，4例为女性。他们的平均年龄为38 +/-A13（范围为22 - 57）岁。在5例患者中观察到完全再通，其临床症状完全恢复（mRS评分0）。1例延迟溶栓的患者在手术后第二天死亡。联合动脉内和静脉内溶栓的血管内治疗可改善严重脑静脉窦血栓形成的神经功能结局。
To investigate the safety and efficacy of endovascular therapy with combined intra-arterial and intravenous thrombolysis for severe cerebral venous sinus thrombosis. Of the 28 consecutive patients with cerebral venous sinus thrombosis admitted to our hospital in recent 3 years, six patients underwent combined intra-arterial and intravenous thrombolysis. For each patient, local contact thrombolysis was performed with balloon catheter to break clot and urokinase infused for thrombolysis in sinus. At the same time, urokinase (100,000 IU/h) was infused intra-arterially via internal carotid artery to dissolve the venous thrombi. Neurologic outcomes, Glasgow coma scale (GCS), neuroimaging results and modified Rankin Scale score (mRS) were recorded. Of the six treated patients, two were males and four females. Their mean age was 38 +/- A 13 (range from 22 to 57) years. Completely recanalization was observed in five patients, whose clinical symptoms recovered completely (mRS score 0). One patient in whom thrombolysis was delayed died the day after the procedure. Endovascular treatment with combined intra-arterial and intravenous thrombolysis may improve neurological outcomes of severe cerebral venous sinus thrombosis.