支架机械取栓联合5F Navien导管抽吸技术治疗颅内大动脉急性闭塞的效果分析

doi:10.3877/cma.j.issn.2095-9141.2019.04.011

目的

探讨支架机械取栓联合5F Navien导管抽吸技术治疗颅内大动脉急性闭塞的有效性及安全性。

方法

选取山西大医院神经外科自2018年2月至11月接受Solitaire支架取栓联合5F Navien导管抽吸技术治疗的14例颅内大动脉急性闭塞患者进行回顾性分析。记录患者入院时及术后24 h美国国立卫生研究院卒中量表（NIHSS）评分、改良脑梗死溶栓试验（mTICI）分级、3个月后改良Rankin量表（mRs）评分等临床资料，并对治疗前后的相关数据进行统计学分析。

结果

颅内大动脉急性闭塞患者术前NIHSS评分[18.0（15.0，20.3）分]高于术后24 h[15.0（13.3，15.8）分]，治疗前后差异有统计学意义（Z=3.193，P=0.001）。治疗后所有患者大动脉均获得良好开通（mTICI分级Ⅱb~Ⅲ级）。随访3个月，10例患者预后良好。

结论

使用支架机械取栓联合5F Navien导管抽吸技术可以改善颅内大动脉急性闭塞患者的近期神经功能及远期临床预后，且不增加患者并发症的发生率，初步研究显示安全有效。

关键词: 颅内大动脉急性闭塞, 支架联合抽吸技术, 机械取栓

Objective

To investigate the effectiveness and safety of stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique for opening the acute occlusion of intracranial large artery.

Methods

This study retrospectively analyzed 14 patients with acute intracranial large artery occlusion treated with Solitaire FR stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique. The National Institutes of Health stroke scale (NIHSS) on admission and at 24 h after operation, modified thrombolysis in cerebral infarction (mTICI), and modified Rankin scale (mRs) 3 months after treatment were documented. The relevant data before and treatment were analyzed.

Results

The NIHSS score of patients with acute intracranial large artery occlusion before operation [18.0 (15.0, 20.3) points] was higher than that 24 h after operation [15.0 (13.3, 15.8) points]. There was significant difference before and after treatment (Z=3.193, P=0.001). After treatment, the large vessels achieved good recanaliazation (mTICI gradeⅡb-Ⅲ). The follow-up for 3 months showed that 10 patients had good prognosis.

Conclusion

Stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique can improve short-term neurological function and long-term prognosis in patients with intracranial occlusion of large artery, without increasing the complication incidence. The preliminary experience showed it was a safe and effective method.

Key words: Intracranial large artery occlusion, Stent combined with catheter suction, Mechanical thrombectomy

图1 急性大脑中动脉闭塞患者Solitaire支架取栓联合5F Navien导管抽吸技术治疗前后的影像学表现

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Efficacy analysis of stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique for the treatment of acute intracranial large vessel occlusion

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Efficacy analysis of stent mechanical thrombectomy combined with 5F Navien catheter aspiration technique for the treatment of acute intracranial large vessel occlusion