ICAS 急性闭塞的血管内治疗单中心经验:首选支架血栓切除术与首选血管成形术。

IF 1.1 4区 医学 Q4 CLINICAL NEUROLOGY
Kechun Chen, Yin Zhou, Gang Guo, Qiuyi Wu
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引用次数: 0

摘要

目的:颅内动脉粥样硬化(ICAS)大血管闭塞的首选血管内疗法(EVT)尚不明确。我们比较了首选支架血栓切除术和首选血管成形术对 ICAS 急性大血管闭塞患者的疗效:回顾性分析了ICAS急性大脑中动脉闭塞的连续EVT患者(2020年5月至2023年9月)的数据。如果术前存在 "微导管首通效应",则首选血管成形术;否则,首选支架血栓切除术。根据两种 EVT 治疗方法进行分组分析。记录并分析所有患者的临床数据,包括从穿刺到再通的时间、再灌注成功率、早期神经功能改善情况、颅内出血情况以及 90 天时的改良 Rankin 量表评分:本研究共纳入 62 名患者(平均年龄(60.66±13.21)岁,女性占 22.6%)。首选血管成形术组的首次再通率高于首选支架血栓切除术组(61.3% vs. 21.9%,P0.05):本研究表明,对于 ICAS 急性大脑中动脉闭塞,首选血管成形术可能是一种安全有效的手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Single-Center Experience With Endovascular Therapy in Acute Occlusion of ICAS: Preferred Stent Thrombectomy Versus Preferred Angioplasty.

Objectives: The preferred endovascular therapy (EVT) for large-vessel occlusion in intracranial atherosclerosis (ICAS) is unknown. We compared the efficacy of preferred stent thrombectomy and preferred angioplasty in patients with acute large-vessel occlusion in ICAS.

Methods: Data from consecutive EVT patients (May 2020 to September 2023) with acute middle cerebral artery occlusion in ICAS were retrospectively analyzed. Preferred angioplasty was performed if there was a preoperative "microcatheter first-pass effect;" otherwise, preferred stent thrombectomy was performed. Analyses were grouped according to the two EVT treatments. Clinical data of all patients, including the time from puncture to recanalization, rate of successful reperfusion, early neurological improvement, intracranial hemorrhage, and modified Rankin Scale score at 90 days, were recorded and analyzed.

Results: Six-two patients were enrolled in this study (mean age was 60.66±13.21 y, 22.6% female). The preferred angioplasty group had a higher first-pass recanalization rate than the preferred stent thrombectomy group (61.3% vs. 21.9%, P <0.001) and a higher proportion of patients who were functionally independent (defined as a modified Rankin Scale score of 0 to 3) at 90 days [odds ratio,3.681; 95% confidence interval (CI):1.009 to 13.428; P =0.048]. There was no significant difference between the groups in the time from puncture to recanalization, the frequency of successful reperfusion, and early neurological improvement, or intracranial hemorrhage ( P >0.05).

Conclusions: This study suggests that for acute middle cerebral artery occlusion in ICAS, preferred angioplasty may be a safe and effective procedure.

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来源期刊
Neurologist
Neurologist 医学-临床神经学
CiteScore
1.90
自引率
0.00%
发文量
151
审稿时长
2 months
期刊介绍: The Neurologist publishes articles on topics of current interest to physicians treating patients with neurological diseases. The core of the journal is review articles focusing on clinically relevant issues. The journal also publishes case reports or case series which review the literature and put observations in perspective, as well as letters to the editor. Special features include the popular "10 Most Commonly Asked Questions" and the "Patient and Family Fact Sheet," a handy tear-out page that can be copied to hand out to patients and their caregivers.
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