由于巨细胞动脉炎引起的侵袭性脊椎骨干狭窄症的内血管治疗:示范性病例
Ryosuke Mizuta1,2, Shoji Saito1,2, Keita Kawabe1,2
1Department of Neurosurgery, Toyama Prefectural Central Hospital, Toyama, Toyama, Japan.
Journal of neurosurgery. Case lessons
|October 21, 2024
概括
巨细胞动脉炎 (GCA) 可以导致严重的脊柱缩. 内血管治疗 (EVT) 能够有效地预防医疗不耐药的GCA患者的复发性中风,特别是当在进一步的缺血事件发生之前进行时.
科学领域:
- 神经学 神经学
- 血管外科 血管外科
- 类风湿病学 类风湿病学
背景情况:
- 巨细胞动脉炎 (GCA) 很少会导致渐进的脊柱缩.
- 脊椎巴性GCA通常对医疗治疗具有抗性,并且具有复发性缺血性中风的高风险.
- 内血管治疗 (EVT) 是一个潜在的选择,但其最佳用途尚未明确定义.
研究的目的:
- 评估EVT在患有医疗不耐药的脊椎基性GCA的患者中的疗效.
- 为了确定EVT的最佳时间,以预防复发性缺血事件.
主要方法:
- 两名患有脊椎基底性GCA的患者的病例报告,他们接受了气球血管造形手术.
- 以后回顾6个额外的脊椎基底性GCA病例,这些病例接受了EVT治疗.
- 血管图分析以区分缺血性并发症的原因.
主要成果:
- 在两名患有双边脊椎动脉狭窄和复发性中风的患者中成功进行了EVT,没有进一步的缺血事件或复缩.
- 所有经过审查的EVT患者都有双边病变,并在30天内经历了复发性中风.
- 血管造影显示血动力学缺血症由狭窄,而不是腹腔内血管炎,作为中风的原因.
- EVT改善了血液流动,缓解了症状,并预防了复发性中风.
结论:
- 医学上不耐药的脊椎基GCA可以导致狭窄症的快速进展和血液动力学缺血症.
- EVT为耐火性脊椎基底性GCA提供了可行的治疗策略.
- 在复发性心脏病发作之前,早期EVT与有利的结果有关.
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