关键词: basilar artery occlusion mechanical thrombectomy recanalization rescue therapy stroke

来  源:   DOI:10.3389/fneur.2022.992396   PDF(Pubmed)

Abstract:
UNASSIGNED: The aim of this study was to evaluate the effectiveness and safety of rescue therapy, a therapy in which rescue devices such as balloon angioplasty, Apollo stent, Wingspan stent, Solitaire stent, or other self-expanding stents are used after the failure of mechanical thrombectomy (MT) and to determine the most effective rescue measure for acute basilar artery occlusion (BAO) after the failure of MT.
UNASSIGNED: For this study, we recruited patients from the BASILAR registry. All participants were divided into three groups: the recanalized with rescue therapy group, the recanalized without rescue therapy group, and the non-recanalized group. Clinical outcomes at 90 days and 1 year were compared. The association of rescue measures with favorable outcomes (modified Rankin Scale [mRS] score of 0-3) in patients achieving successful recanalization via rescue therapy was estimated using multivariate logistic regression analyses.
UNASSIGNED: Among the participants, recanalization failure was found in 112 patients and successful recanalization in 473 patients, with 218 patients receiving rescue therapy and 255 patients without rescue therapy. Of these, 111 (43.5%) patients in the recanalized without rescue therapy group, 65 (29.8%) patients in the recanalized with rescue therapy group, and nine (8.0%) patients in the non-recanalized group achieved favorable outcomes at 90 days. Both the recanalization with rescue therapy and the recanalization without rescue therapy groups were associated with favorable outcomes at 90 days and 1 year compared with the non-recanalized group. Moreover, in patients receiving rescue therapy, Wingspan stents, Apollo stents, and balloon angioplasty were associated with higher rates of favorable outcomes at 90 days and 1 year than Solitaire stents.
UNASSIGNED: Whether rescue therapy is administered or not, recanalization leads to favorable outcomes in patients with acute BAO. For acute BAO after MT failure, balloon angioplasty, Wingspan stenting, and Apollo stenting could be considered effective and safe rescue options but not Solitaire stenting.
摘要:
未经评估:本研究的目的是评估抢救治疗的有效性和安全性,一种治疗方法,其中救援装置,如球囊血管成形术,阿波罗支架,翼展支架,接龙支架,在机械血栓切除术(MT)失败后使用或其他自膨胀支架,并确定MT失败后急性基底动脉闭塞(BAO)的最有效抢救措施。
未经批准:对于这项研究,我们从BASILAR登记处招募患者.将所有参与者分为三组:再治疗与抢救治疗组,没有抢救的再通治疗组,和非重组组。比较90天和1年的临床结果。使用多变量逻辑回归分析估计通过抢救治疗成功再通的患者的抢救措施与有利结果(改良Rankin量表[mRS]评分为0-3)的关联。
未经评估:在参与者中,112例患者再通失败,473例患者再通成功,218例患者接受抢救治疗,255例未接受抢救治疗。其中,111例(43.5%)患者在再通无抢救治疗组中,65例(29.8%)患者在再通抢救治疗组,非再通组中有9例(8.0%)患者在90天时取得了良好的结局.与未再通组相比,有抢救治疗的再通组和无抢救治疗的再通组在90天和1年均具有良好的预后。此外,在接受抢救治疗的患者中,翼展支架,阿波罗支架,与Solitaire支架相比,球囊血管成形术在90天和1年时具有更高的有利结局。
未经授权:无论是否进行抢救治疗,再通导致急性BAO患者的良好结局。对于MT故障后的急性BAO,球囊血管成形术,翼展支架术,和Apollo支架可以被认为是有效和安全的救援选择,但不是Solitaire支架。
公众号