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首页> 美国卫生研究院文献>Neurologia medico-chirurgica >Outcomes of Endovascular Thrombectomy Performed 6–24 h after Acute Stroke from Extracranial Internal Carotid Artery Occlusion
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Outcomes of Endovascular Thrombectomy Performed 6–24 h after Acute Stroke from Extracranial Internal Carotid Artery Occlusion

机译：颅内颈内动脉阻塞急性卒中后6-24小时进行血管内血栓切除术的结果

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Thrombectomy has demonstrated clinical efficacy against acute ischemic stroke caused by intracranial occlusion of the internal carotid artery (ICA), even if performed 6–24 h after onset. This study investigated the outcomes of thrombectomy performed 6–24 h after stroke onset caused by extracranial ICA occlusion. Of 586 stroke patients receiving thrombectomy during the past 3 years and registered in the Tama Registry of Acute Endovascular Thrombectomy database, 24 were identified with ICA occlusion (14 extracranial and 10 intracranial), known to be well 6–24 h before presentation, and with pre-stroke modified Rankin Scale (mRS) score of 0 or 1. Clinical outcomes measured were the rate of functional independence at 90 days according to mRS score of 0–2 and 90 day mortality rate. Of patients with extracranial ICA occlusion, two received additional carotid stenting with thrombectomy. The median interval between the last time the patient was known to be well and hospital arrival was 601 (interquartile range, 476–729 min). Both the rate of functional independence at 90 days and 90 day mortality were comparable between patients with extracranial or intracranial ICA occlusion (36% vs. 40% and 7% vs. 10%, respectively). No symptomatic intracranial hemorrhages occurred within 24 h following treatment of extracranial ICA occlusion. Thrombectomy performed 6–24 h after extracranial ICA results in acceptable functional outcome. Further clinical study is warranted to better define the temporal window of thrombectomy for acceptable functional outcome in patients with extracranial ICA occlusion.
机译：血栓切除术已证明对颈内动脉（ICA）颅内闭塞引起的急性缺血性卒中具有临床疗效，即使在发病后6–24 h进行。这项研究调查了由颅外ICA闭塞引起的卒中发作后6-24小时进行的血栓切除术的结果。在过去3年中接受TAMA登记的急性血管内血栓切除术数据库中登记的586例卒中患者中，有24例被确诊为ICA闭塞（14例颅外和10例颅内），已知在出院前6-24 h以及脑卒中前改良的Rankin量表（mRS）评分为0或1。根据mRS评分0–2和90天死亡率，测量的临床结局为90天时的功能独立率。在颅外ICA闭塞的患者中，有两名接受了附加的颈动脉支架并进行了血栓切除术。上一次已知患者康复情况良好与到达医院之间的平均时间间隔为601（四分位间距为476–729分钟）。颅外或颅内ICA闭塞患者在90天和90天死亡率时的功能独立率均相当（分别为36％vs. 40％和7％vs. 10％）。颅外ICA封堵治疗后24小时内未出现任何症状性颅内出血。颅外ICA术后6-24 h进行血栓切除术，可取得可接受的功能预后。有必要进行进一步的临床研究，以更好地定义颅外ICA闭塞患者可接受的功能预后的血栓切除术的时间窗。

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