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首页> 外文期刊>AJNR. American journal of neuroradiology >Recanalization rates decrease with increasing thrombectomy attempts.
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Recanalization rates decrease with increasing thrombectomy attempts.

机译：再通率随血栓切除术尝试次数的增加而降低。

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BACKGROUND AND PURPOSE: Use of the Merci retriever is increasing as a means to reopen large intracranial arterial occlusions. We sought to determine whether there is an optimum number of retrieval attempts that yields the highest recanalization rates and after which the probability of success decreases. MATERIALS AND METHODS: All consecutive patients undergoing Merci retrieval for large cerebral artery occlusions were prospectively tracked at a comprehensive stroke center. We analyzed ICA, M1 segment of the MCA, and vertebrobasilar occlusions. We compared the revascularization of the primary AOL with the number of documented retrieval attempts used to achieve that AOL score. For tandem lesions, each target lesion was compared separately on the basis of where the device was deployed. RESULTS: We identified a total of 97 patients with 115 arterial occlusions. The median number of attempts per target vessel was 3, while the median final AOL score was 2. Up to 3 retrieval attempts correlated with good revascularization (AOL 2 or 3). When >or=4 attempts were performed, the end result was more often failed revascularization (AOL 0 or 1) and procedural complications (P = .006). CONCLUSIONS: In our experience, 3 may be the optimum number of Merci retrieval attempts per target vessel occlusion. Four or more attempts may not improve the chances of recanalization, while increasing the risk of complications.
机译：背景与目的：作为重新打开大颅内动脉闭塞的手段，Merci猎犬的使用正在增加。我们试图确定是否存在产生最高再通率的最佳检索尝试次数，此后成功的可能性降低。材料与方法：前瞻性地在综合性卒中中心追踪所有因大脑动脉闭塞而进行Merci检索的连续患者。我们分析了ICA，MCA的M1节段和椎基底动脉闭塞。我们将主要AOL的血运重建与用于实现该AOL得分的文献检索尝试次数进行了比较。对于串联病变，根据设备的部署位置分别比较每个目标病变。结果：我们确定了总共97例115例动脉阻塞的患者。每个目标血管的中位尝试次数为3，而最终AOL得分中位数为2。最多3次检索尝试与良好的血运重建相关（AOL 2或3）。当尝试≥4次时，最终结果更多是血管重建术失败（AOL 0或1）和手术并发症（P = .006）。结论：根据我们的经验，每个目标血管阻塞的最佳Merci检索尝试次数可能为3次。尝试四次或更多次可能不会增加再通的机会，同时会增加发生并发症的风险。

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