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首页> 美国卫生研究院文献>Journal of Clinical Medicine >Mechanical Thrombectomy in Stroke. Experience from Switching from Stent Retriever Only to Stent Retriever Combined with Aspiration Catheter
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Mechanical Thrombectomy in Stroke. Experience from Switching from Stent Retriever Only to Stent Retriever Combined with Aspiration Catheter

机译：中风机械血栓切除术。从支架猎犬切换到支架猎犬的经验与吸入导管相结合

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Endovascular treatment is a rapidly evolving technique; therefore, there is a constant need to evaluate this method and its modifications. This paper discusses a single-center experience and the results of switching from the stent retriever only (SO) mechanical thrombectomy (MT) to the combined approach (CA), with a stent retriever and aspiration catheters. Methods: The study involved a retrospective analysis of 70 patients undergoing MT with the use of either SO or CA. The primary endpoint was the frequency of perfect reperfusion defined as grade 3 of the modified Thrombolysis in Cerebral Infarction scale (mTICI) after the first pass. The secondary endpoints were the procedure success, defined as mTICI grades 2b-3; time of the procedure; clinical outcome, measured by 90 days’ modified Rankin Scale (mRS) score; Δ NIHSS, defined as the difference between National Institutes of Health Stroke Scale (NIHSS) score at patients’ admission and discharge; and the total number of device passes. Results: Out of the 70 patients included, 33 were treated with SO and 37 with CA. In both groups, a total number of 42 patients received intravenous recombined tissue plasminogen activator (iv-rTPA: 20 patients (60.6%) in the SO group and 22 patients (59.5%) in the CA group (p = 1.000). There was a significant difference between the groups regarding first-pass success rate, with 46% in the CA group and 18% in the SO group, (OR 3.83, 95% CI 1.28 to 11.44, p = 0.016). Complete procedure success tended to be more frequent in the CA group than in the SO group—94.6% vs. 84.8% (OR 3.13, 95% CI 0.56 to 17.34, p = 0.193)—and CA tended to require a lower number of passes than SO (mean 1.76 vs. 2.09 passes per procedure, p = 0.114), yet these differences did not reach statistical significance. Mean duration of the procedure was significantly shorter in the CA group than in the SO group (49 min vs. 64 min, p = 0.017). There was a significant difference in clinical outcomes, with higher Δ NIHSS (9.3 in the CA group vs. 6.7 in the SO group, p = 0.025) after the procedure and 90-day mRS (median 2 in the CA group vs. 4 in the SO group, p = 0.031). Conclusions: Combining stent retrievers with aspiration catheters may offer a beneficial effect on angiographic results and clinical outcomes in stroke patients undergoing endovascular treatment.
机译：血管内治疗是一种迅速发展的技术;因此，存在持续评估该方法及其修改。本文讨论了单中心的经验和从支架猎犬（SO）机械血栓切除术（MT）切换到组合方法（CA）的结果，具有支架猎犬和抽吸导管。方法：该研究涉及70名患者的回顾性分析，使用所以或CA的使用。主要终点是在第一次通过后定义为脑梗死尺度（MTICI）的改性溶栓的第3级定义的完美再灌注。辅助端点是程序成功，定义为MTICI等级2B-3;程序的时间;临床结果，在90天改进的Rankin规模（MRS）得分中测量; δniHSS，定义为国家卫生冲程量表（NIHSS）征收和排放的国家卫生冲程量表（NIHSS）的差异;并且设备的总数通过。结果：除了70例中，包含33名患者，用CA用37种。在两组中，42例患者的总数接受静脉内重组组织纤溶酶原激活剂（SO组中的IV-RTPA：20名患者（60.6％），Ca组中的22例（59.5％）（P = 1.000）。有关于第一遍成功率的组之间的显着差异，Ca组中46％，其中18％，（或3.83,95％CI 1.28至11.44，P = 0.016）。完成程序成功趋于在Ca组中更常见于此组-94.6％与84.8％（或3.13,95％CI 0.56至17.34，P = 0.193） - 以及CA往往需要较低的通行证（平均1.76 Vs 。2.09每次通过P = 0.114），但这些差异没有达到统计学意义。Ca组的平均持续时间明显短于SO组（49分钟与64分钟，P = 0.017）。临床结果有显着差异，Δnihss（9.3在该组中的Ca组中9.3，P = 0.025）和90-天夫人（CA组中位数2中的中位数2，SO组，P = 0.031）。结论：将支架检索与吸入导管相结合，可以对血管内治疗的中风患者的血管造影结果和临床结果提供有益的影响。

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