動脈內取栓治療於年輕腦中風族群的分析

罹患腦中風對個人、家庭及社會造成的衝擊，最主要分別為失能、照護及生產力的影響，若年輕人發生這樣的不幸，所帶來的影響更是顯著。最近兩三年的時間，臨床上使用導管技術，配合抽吸導管或取栓器（一種可回收式的支架），直接於動脈內移除血栓，讓缺血的腦組織及時恢復血液灌流的比例愈來愈高。在急性缺血性腦中風合併大血管阻塞的患者，已經證實能有效降低日後失能的嚴重度。然而，目前大多數臨床研究的結果，多半反應在腦中風好發的年齡層，也就是60歲以上年老的族群。45歲以下年輕的腦中風患者，是否同樣受益於直接動脈移除血栓的治療，或者因為年輕型的腦中風，多半合併有特別的病因，其預後會有不同的影響，相關文獻資料較為欠缺。本篇的目的就在籍由臨床案例的分析，做一個初步的探討，期能增加我們對於疾病治療效果更進一步的認識。

關鍵字

動脈取栓；機械取栓；缺血性腦中風；青年腦中風

並列摘要

The major impacts of ischemic brain stroke on individuals, families and societies are disability, caring and economy. If those stroke patients are young age, the impact would be remarkable. Recently, applying endovascular technique with aspiration catheters or stent retriever to remove blood clots has been making a significant progress. Owing to its high recanalization rate, the endovascular thrombectomy has been proved an effective treatment for acute ischemic stroke with large arteries occlusion, in terms of minimizing severity and disability of patients. However, most clinical studies only reflect the therapeutic results in elderly, i.e. the most prevalent population in stroke. For young stroke patients, reports of causal relation and treatment results with endovascular thrombectomy are limited in literature. In this case series, we reviewed the results of endovascular thrombectomy in young stroke patients associated with specific etiologies.

並列關鍵字

endovascular thrombectomy ； mechanical thrombectomy ； acute ischemic stroke ； young stroke

參考文獻

Powers WJ, Derdeyn CP, Biller J, et al: 2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke 2015;46:3020-35.

Mocco J, Tawk RG, Jahromi BS, et al: Endovascular intervention for acute thromboembolic stroke in young patients: an ideal population for aggressive intervention? J Neurosurg 2009;110:30-4.

Chalouhi N, Tjoumakaris S, Starke RM, et al: Endovascular stroke intervention in young patients with large vessel occlusions. Neurosurg Focus 2014; 36:E6.

Zanaty M, Chalouhi N, Starke RM, et al: Endovascular stroke intervention in the very young. Clin Neurol Neurosurg 2014; 127:15-8.

Renna R, Pilato F, Profice P, et al: Risk factor and etiology analysis of ischemic stroke in young adult patients. J Stroke Cerebrovasc Dis 2014; 23:e221-7.

國際替代計量

動脈內取栓治療於年輕腦中風族群的分析

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