支架样取栓装置对急性缺血性卒中血管再通治疗临床效果观察

doi:10.3969/j.issn.1673-5765.2018.04.006

摘要/Abstract

摘要：

目的探讨应用支架样取栓装置对前循环大动脉闭塞所致急性缺血性卒中患者机械取栓治疗的临床效果。方法连续纳入采用支架样取栓装置治疗的前循环急性颅内大动脉近端闭塞患者。分析纳入患者的临床特征、影像学资料、治疗及术后90 d临床随访结果。以术后90 d改良Rankin量表（modified Rankin Scale，mRS）评分为主要指标评估治疗有效性，以症状性颅内出血率、术后90 d死亡率评估治疗的安全性。结果共纳入30例患者，29例应用Solitaire，1例应用Trevo。平均年龄（65.97±11.67）岁。入院时美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale，NIHSS)评分中位数13.50（9.75， 18.00）。包括颈内动脉闭塞9例，大脑中动脉M1段闭塞20例，大脑前动脉A1段闭塞1例。术后90 d随访， 56.7%（17/30）患者预后良好（mRS评分0～2分）。术后发生症状性颅内出血率13.3%（4/30），术后 90 d死亡率20%（6/30）。结论支架样取栓装置在前循环大动脉闭塞性急性缺血性卒中取栓治疗中临床效果较好，其有效性、安全性能够在真实世界中得到体现，是治疗急性颅内大动脉闭塞的有效方法。

文章导读： 本研究通过翔实的评估与随访工作对支架样取栓装置在急性前循环大动脉闭塞卒中超急性期血运重建治疗在实际临床实践中的有效性与安全性进行验证与观察。

关键词: 缺血性卒中; 血管内治疗; 支架样取栓装置; 机械取栓

Abstract:

Objective To investigate the clinical effect of stent-like retrievers for mechanical thrombectomy in ischemic stroke patients due to large vessel occlusion. Methods Patients treated with stent-like retrievers for mechanical thrombectomy caused by proximal arterial occlusion in anterior cerebral circulation were enrolled consecutively. Their clinical features, imaging data, treatments and the results of 90-day follow up were analyzed. The major efficacy measure was assessed with modified Rankin Scale (mRS) at 90 days after onset. The safety measures were assessed with symptomatic intracranial hemorrhage (sICH) and mortality at 90 days. Results Of the 30 enrolled patients, 29 were treated with Solitaire and 1 with Trevo. The mean age was (65.97±11.67) years old, and median baseline National Institutes of Health Stroke Scale (NIHSS) score was 13.50 (9.75, 18.00). Nine of them had internal carotid artery occlusion, 20 had the M1 segment of the middle cerebral artery occlusion and 1 had the A1 segment of the anterior cerebral artery occlusion. The proportion of favorable functional outcome (mRS 0-2 at 90 days) was 56.7% (17/30). sICH rate was 13.3% (4/30), and the mortality at 90 days was 20% (6/30). Conclusion The effect of stent-like retrievers for mechanical thrombectomy in ischemic stroke patients due to anterior cerebral circulation large vessel occlusion is relatively good. Its efficacy and safety can be reflected in the real world, and it is an effective method for the treatment of acute intracranial artery occlusion.

Key words: Ischemic stroke; Endovascular treatment; Stent-like retrievers; Mechanical thrombectomy

张帅, 王润榕, 侯红玲, 任彬彬, 刘振生, 王苇, 陈斌, 张新江. 支架样取栓装置对急性缺血性卒中血管再通治疗临床效果观察[J]. 中国卒中杂志, 2018, 13(04): 322-326.

ZHANG Shuai, WANG Run-Rong, HOU Hong-Ling, REN Bin-Bin, LIU Zhen-Sheng, WANG Wei, CHEN Bin, ZHANG Xin-Jiang . Clinical Effect Observations of Stent-like Retrievers in Ischemic Stroke Patients with Mechanical Thrombectomy[J]. Chinese Journal of Stroke, 2018, 13(04): 322-326.

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