PDF(Pubmed)
Abstract：
BACKGROUND: Endovascular recanalization of non-acute intracranial artery occlusion is technically difficult, particularly when the microwire enters the subintima. Although the subintimal tracking and re-entry technique has been well established in the endovascular treatment of coronary artery occlusion, there is limited experience with its use in intracranial occlusion due to anatomical variations and a lack of dedicated devices.
METHODS: A 74-year-old man was admitted to the hospital two days after experiencing acute weakness in both lower extremities, poor speech, and dizziness. After admission, imaging revealed acute ischemic stroke and non-acute occlusion of bilateral intracranial vertebral arteries (ICVAs). On the fourth day of admission, the patient\'s condition deteriorated and an emergency endovascular recanalization of the left ICVA was performed. During this procedure, a microwire was advanced in the subintima of the vessel wall and successfully reentered the distal true lumen. Two stents were implanted in the subintima. The patient\'s Modified Rankin Scale was 1 at three months postoperatively.
CONCLUSIONS: We present a technical case of subintimal recanalization for non-acute ICVA occlusion in an emergency endovascular procedure. However, we emphasize the necessity for caution when applying the subintimal tracking approach in intracranial occlusion due to the significant dangers involved.
METHODS: A 74-year-old man was admitted to the hospital two days after experiencing acute weakness in both lower extremities, poor speech, and dizziness. After admission, imaging revealed acute ischemic stroke and non-acute occlusion of bilateral intracranial vertebral arteries (ICVAs). On the fourth day of admission, the patient\'s condition deteriorated and an emergency endovascular recanalization of the left ICVA was performed. During this procedure, a microwire was advanced in the subintima of the vessel wall and successfully reentered the distal true lumen. Two stents were implanted in the subintima. The patient\'s Modified Rankin Scale was 1 at three months postoperatively.
CONCLUSIONS: We present a technical case of subintimal recanalization for non-acute ICVA occlusion in an emergency endovascular procedure. However, we emphasize the necessity for caution when applying the subintimal tracking approach in intracranial occlusion due to the significant dangers involved.
摘要：
背景：非急性颅内动脉闭塞的血管内再通在技术上是困难的，特别是当微丝进入内膜下。尽管在冠状动脉闭塞的血管内治疗中已经很好地建立了内膜下跟踪和再进入技术，由于解剖结构变化和缺乏专用设备,其在颅内闭塞中的使用经验有限.
方法：一名74岁男子在双下肢急性无力两天后入院，糟糕的演讲,和头晕。入院后,影像学显示急性缺血性卒中和双侧颅内椎动脉非急性闭塞（ICVA）。在入学的第四天，患者病情恶化,并对左ICVA行紧急血管内再通.在此过程中,一根微丝在血管壁内膜下推进,并成功重新进入远端真腔.在内膜下植入两个支架。患者的改良Rankin量表在术后3个月为1。
结论：我们介绍了在紧急血管内手术中用于非急性ICVA闭塞的内膜下再通的技术案例。然而,由于涉及重大危险,我们强调在颅内闭塞中应用内膜下追踪方法时必须谨慎.
方法：一名74岁男子在双下肢急性无力两天后入院，糟糕的演讲,和头晕。入院后,影像学显示急性缺血性卒中和双侧颅内椎动脉非急性闭塞（ICVA）。在入学的第四天，患者病情恶化,并对左ICVA行紧急血管内再通.在此过程中,一根微丝在血管壁内膜下推进,并成功重新进入远端真腔.在内膜下植入两个支架。患者的改良Rankin量表在术后3个月为1。
结论：我们介绍了在紧急血管内手术中用于非急性ICVA闭塞的内膜下再通的技术案例。然而,由于涉及重大危险,我们强调在颅内闭塞中应用内膜下追踪方法时必须谨慎.
