| 摘要: |
| ［摘要］ 目的 分析颈动脉内膜剥脱术（CEA）联合血管内治疗在Hasan分型A型、B型慢性颈内动脉闭塞（CICAO）患者中的应用效果。方法 回顾性分析2020年6月至2024年6月新疆医科大学第一附属医院神经外科收治的34例Hasan分型A型、B型CICAO患者的临床资料。所有患者均行CEA联合血管内治疗。观察闭塞血管再通情况、围手术期并发症发生情况和神经功能恢复情况。结果 34例患者中28例成功开通闭塞血管，再通率为82.35%。其中A型再通率为89.47%（17/19），B型再通率为73.33%（11/15），两者再通率比较差异无统计学意义（P>0.05）。28例闭塞血管再通成功患者中，6例出现围手术期并发症，其中A型3例，B型3例；神经功能恢复良好25例，其中A型14例，B型11例；神经功能恢复不良3例，均为A型患者；术后血管再狭窄2例，均为A型患者。6例闭塞血管再通失败患者中A型2例，B型4例。结论 Hasan分型A型、B型CICAO患者行CEA联合血管内治疗成功率较高，围手术期并发症较少，术后神经功能恢复及血管通畅情况良好，是一种安全有效的治疗方式。 |
| 关键词: 慢性颈内动脉闭塞 Hasan分型 内膜剥脱术 血管内治疗 围手术期并发症 疗效 |
| DOI：10.3969/j.issn.1674-3806.2025.08.08 |
| 分类号: |
| 基金项目:省部共建中亚高发病成因与防治国家重点实验室开放课题项目（编号：SKL-HIDCA-2022-NKX） |
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| Analysis on application effect of carotid endarterectomy combined with endovascular therapy in patients with Hasan classification type A or B chronic internal carotid artery occlusion |
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ZHANG Xiaojie, MAIMAITILI Aisha, KAHEERMAN Kadeer, WANG Kai, NIZHAMIDINGJIANG Rexiati, JIANG Shihao, GUO Ke, CHENG Xiaojiang
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Department of Neurosurgery, the First Teaching Hospital of Xinjiang Medical University, Urumqi 830054, China
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| Abstract: |
| ［Abstract］ Objective To analyze the application effect of carotid endarterectomy(CEA) combined with endovascular therapy in patients with Hasan classification type A or B chronic internal carotid artery occlusion(CICAO). Methods A retrospective analysis was conducted on the clinical data of 34 patients with Hasan classification type A or B CICAO who were admitted to Department of Neurosurgery, the First Teaching Hospital of Xinjiang Medical University from June 2020 to June 2024. All the patients underwent CEA combined with endovascular therapy. The recanalization of the occluded blood vessels, the occurrence of perioperative complications and recovery of neurological function were observed. Results In the 34 patients, the occluded blood vessels were successfully recanalized in 28 patients, with a recanalization rate of 82.35%. The recanalization rate of the patients with Hasan classification type A was 89.47%(17/19), and that of the patients with Hasan classification type B was 73.33%(11/15). There was no statistically significant difference in the recanalization rate between the patients with Hasan classification type A and the patients with Hasan classification type B(P>0.05). In the 28 patients with successful recanalization of the occluded vessels, perioperative complications occurred in 6 patients, including 3 cases of Hasan classification type A and 3 cases of Hasan classification type B. In the 28 patients with successful recanalization of the occluded vessels, 25 patients had good prognosis, including 14 cases of type A and 11 cases of type B, and 3 patients had poor prognosis, all of whom were the patients with Hasan classification type A. There were 2 cases of postoperative vascular restenosis, both of whom were the patients with Hasan classification type A. In 6 patients with failed recanalization of the occluded vessels, there were 2 cases of type A and 4 cases of type B. Conclusion The success rate of CEA combined with endovascular therapy is relatively high in patients with Hasan classification type A or B CICAO, with less perioperative complications, good neurological function recovery and vessel patency after operation. CEA combined with endovascular therapy is a safe and effective treatment method. |
| Key words: Chronic internal carotid artery occlusion(CICAO) Hasan classification Endarterectomy Endovascular therapy Perioperative complications Therapeutic efficacy |
