摘要
目的 通过与传统支架取栓（CSRT）比较,评价钳夹取栓治疗急性脑梗死的安全性及有效性.方法 回顾性分析2015年1月至2016年11月经Solitaire支架取栓治疗的42例急性颅内大血管栓塞患者的影像及临床资料.依取栓方法不同分为CSRT组与钳夹取栓组,比较两组患者的血管再通率、取栓次数、单次取栓成功率、手术时间、术后蛛网膜下腔出血（subarachnoid hemorrhage,SAH）及3个月改良Rankin量表（mRS）评分等资料.结果 钳夹取栓组20例,CSRT组22例,两组患者的血管再通率分别为90.0%（18/20）和90.9%（20/22）,术后SAH的发生率分别为10.0%（2/20）和13.6%（3/22）,预后良好（mRS评分≤2分）患者的比例分别为60.0%（12/20）和59.1%（13/22）,差异均无统计学意义（均P〉0.05）.钳夹取栓组的平均取栓次数[（1.7±0.5）次与（2.6±0.8）次,t=2.118,P=0.040]、手术时间[（36.8±8.6）min与（55.5±10.5）min,t=-3.493,P=0.001]明显低于CSRT组,钳夹取栓组患者的单次取栓成功率明显高于CSRT组[60.0%（12/20）与22.7%（5/22）,χ^2=6.041,P=0.014],差异均有统计学意义.结论 钳夹取栓治疗急性脑梗死安全可行,也许能够提高颅内大血管栓塞的机械取栓效率.
Objective To evaluate the safety and efficiency of thrombectomy with clamping embolus technique （ TCET ） by partial retrieving stent comparing with conventional stent retrievers thrombectomy （CSRT） for acute ischemic stroke.Methods Retrospective analysis was performed in 42 consecutive patients treated by stent retrievers thrombectomy between January 2015 and November 2016 for acute intracranial large vessel embolism . Data on recanalization rates , procedure duration , thrombectomy attempts, one-pass rate, postoperative subarachnoid hemorrhage （SAH）,and modified Rankin Scale （mRS） score during 90 days follow-up were compared between TCET and CSRT groups .Results Recanalization rate was 90.0%（18/20） in TCET group and 90.9% （20/22） in CSRT group, post-procedural SAH was 10.0%（2/20） in TCET group and 13.6% （3/22） in CSRT group, good outcome （mRS score≤2） was 60.0%（12/20） in TCET group and 59.1% （13/22） in CSRT group, all without significant differences （P〉0.05）.The number of thrombectomy attempts with TCET was significantly lower than that with CSRT （1.7 ±0.5 vs 2.6 ±0.8, t=2.118, P=0.040）, the procedure duration with TCET was significantly shorter than that with CSRT （ （36.8 ±8.6） min vs （55.5 ±10.5） min, t=-3.493, P=0.001） and one-pass thrombectomy rate with TCET was significantly higher than that with CSRT （ 60.0% （ 12/20 ） vs 22.7%（5/22）, χ^2 =6.041,P=0.014） .Conclusion TCET is safe and feasible for acute ischemic stroke and might improve the efficiency of thrombectomy comparing with CSRT .
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2017年第10期751-756,共6页
Chinese Journal of Neurology
关键词
脑梗塞
放射学
介入性
导管插入术
血栓清除
Brain infarction
Radiology, interventional
Catheterization
Thrombectomy
