目的:我们的研究旨在评估安全性,急性缺血性卒中M2段闭塞患者血栓抽吸治疗的疗效和临床结局。
方法:对接受血管内血栓抽吸术的M2段缺血性卒中患者进行回顾性研究。分析的时间段是从2015年10月到2021年2月。用AXS催化剂5(Stryker)或AXS催化剂6(Stryker)导管进行血栓抽吸。评估了以下参数:缺血性卒中的危险因素,美国国立卫生研究院卒中量表(入学和出院),术前纤维蛋白溶解,术前和24小时Alberta卒中计划早期CT评分,再通时间,再通的通道数,脑梗死溶栓量表评分,围手术期并发症,手术和死亡率后90天的改良Rankin量表评分。
结果:90例患者被纳入研究。出院时,美国国立卫生研究院卒中量表第13±5和8±4条,平均年龄为75±11.1。40例患者进行了术前纤维蛋白溶解。术前Alberta卒中计划术后24小时早期CT评分分别为8.8±1.3和6.9±2.4。从症状开始再通的时间为300±82分钟。再通通道数为1.8±1.1。在90%的程序中,脑梗死的溶栓评分≥2b。90天后,33%的患者获得了0至1之间的改良Rankin量表(0至2之间为40%)。我们在64%的病例中未发现任何并发症(2%的蛛网膜下腔出血,HI1和HI2占15%,PH1在9%的患者中,6%的患者中的PH2)。
结论:本文证实了低手术风险的M2段缺血性卒中患者血栓性的有效性和安全性,技术上的成功和对患者预后的积极影响。
OBJECTIVE: Our study aimed to evaluate safety, efficacy and clinical outcomes in patients with acute ischemic stroke with occlusion of M2 segment treated with thromboaspiration.
METHODS: A retrospective study was conducted in patients with ischemic stroke of M2 segment undergoing endovascular thromboaspiration. The time period analyzed was from October 2015 until February 2021. Thromboaspiration was performed with AXS Catalyst 5 (Stryker) or AXS Catalyst 6 (Stryker) catheters. The following parameters were assessed: risk factors for ischemic stroke, National Institutes of Health Stroke Scale (entry and discharge), pre-procedural fibrinolysis, pre-procedural and 24-h Alberta Stroke Program Early CT Score, recanalization time, number of passages for recanalization, Thrombolysis in cerebral infarction scale score, periprocedural complications, Modified Rankin Scale score at 90 days from procedure and mortality.
RESULTS: 90 patients were included in the study. The mean age was 75 ± 11.1 with National Institutes of Health Stroke Scale at entry 13 ± 5 and 8 ± 4 at discharge. Pre-procedural fibrinolysis were performed in 40 patients. Pre-procedural Alberta Stroke Program Early CT Score were 8.8 ± 1.3 and 6.9 ± 2.4 after 24 h from the procedure. Time of recanalization from onset of symptoms was 300 ± 82 min. Number of passages for recanalization were 1.8 ± 1.1. Thrombolysis in cerebral infarction scale score ≥ 2b were obtained in 90 % of procedures. After 90 days 33 % of patient obtained an Modified Rankin Scale between 0 and 1 (between 0 and 2 was 40 %). We didn\'t detect any complication in 64 % of cases (subarachnoid haemorrhage in 2 %, HI1 and HI 2 in 15 %, PH1 in 9 % of patients, PH2 in 6 % of patients).
CONCLUSIONS: This paper confirms the usefulness and safety of thrombospiration in patients with ischemic stroke in the M2 segment with low intra-operative risks, high technical success and positive impact on the outcome of the patients.