目的 探讨Penumbra抽吸系统联合Trevo取栓器治疗颅内大动脉急性闭塞的临床效果.方法 收集2016年11月至12月采用ACETM取栓器联合Trevo可视性取栓支架机械取栓治疗的5例颅内大动脉急性梗死患者临床资料.其中前循环闭塞2例,后循环闭塞3例;平均(60.4±11.6)岁.术后观察患者取栓时间、闭塞血管再通和神经功能恢复情况.结果 5例患者穿刺-血管再通时间分别为29 min、32 min、35 min、33 min、30 min,平均(31.8±2.4) min;术中脑梗死溶栓(TICI)治疗后血流分级均达到3级;NIHSS评分由术前(11.0±7.4)分明显改善至术后24 h(4.2±1.1)分、7 d(1.8±1.3)分、30 d(0.9±0.6)分(P＜0.05);改良Rankin量表(mRS)评分均为0～2分,且未发生颅内出血转化.结论 ACETM取栓器联合Trevo取栓支架机械取栓治疗颅内大动脉急性梗死,在取栓次数少、取栓时间短情况下,取得了最佳血管再通效果,临床预后良好.%Objective To discuss the clinical effect of Penumbra aspiration system combined with Trevo thrombectomy device in treating acute intracranial main artery infarction.Methods The clinical data of a total of 5 patients with acute intracranial main artery infarction,who were treated with ACETM thrombectomy device combined with Trevo visible thrombectomy stent,were retrospectively analyzed.The lesions included anterior circulation infarction (n=2) and posterior circulation infarction (n=3).The mean age of patients was (60.4±11.6) years old.The operation time spent for thrombectomy,the recanalization time of occluded vessels,and the recovery of neural function were assessed.Results The puncture-recanalization intervals in the 5 patients were 29 min,32 min,35 min,33 min and 30 min respectively,with a mean time of (31.8±2.4) min.After intraoperative cerebral infarction thrombolysis treatment,the cerebral blood flow grading reached level 3.NIHSS score was remarkably improved from preoperative (11.0±7.4) points to 24 hpostoperative(4.2±1.1) points,to 7 days-postoperative(1.8±1.3) points,and to 30 days-postoperative (0.9±0.6) points (P＜0.05).Modified Rankin scale (mRS) score was 0-2 points in all patients.No intracranial hemorrhage transformation occurred.Conclusion In treating acute intracranial main artery infarction,ACETM thrombectomy device combined with Trevo visible thrombectomy stent can achieve the best recanalization effect with less times of thrombectomy procedure and short operation time.The clinical prognosis is satisfactory.
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