8F导引导管抽吸联合其他取栓技术在急性颈内动脉闭塞机械取栓中的应用

Application of Combined 8F Guide Catheter Suction with Other Thrombectomy Techniques in Patients with Acute Internal Carotid Artery Occlusion

目的探讨8F导引导管抽吸联合其他取栓技术在急性颈内动脉闭塞患者机械取栓治疗中的有效性及安全性。方法回顾性分析2016年1月至2019年11月广东省人民医院神经科收治的52例急性颈内动脉闭塞患者,病因分型均为心源性脑栓塞。根据是否联合8F导引导管抽吸治疗分为观察组和对照组,收集并分析两组患者的年龄、性别、高血压、糖尿病、ASPECT、NIHSS评分等基线资料及桥接治疗、发病至穿刺时间(OTP)、穿刺至血管再通时间(PTR)、取栓技术、取栓次数、血管再通情况、无症状性脑出血(aSICH)、症状性脑出血(SICH)、术后90 d mRS评分等临床资料。结果(1)两组患者的基线资料均无统计学差异(P>0.05)。(2)两组患者桥接治疗、OTP、PTR、取栓技术、sICH、aSICH的差异均无统计学意义(P>0.05)。观察组与对照组平均取栓次数分别为2.1、3.0次,组间差异有统计学意义(P=0.009)。观察组手术再通成功23例,术后90 d mRS预后良好17例,对照组手术再通成功11例,术后90 d mRS预后良好7例,两组间差异有统计学意义(P<0.05)。结论应用8F导引导管抽吸联合其他取栓技术能够提高心源性脑栓塞所致急性颈内动脉闭塞患者的取栓效果,具有一定临床推广价值。

Objective To investigate the effectiveness and safety of 8F guide catheter combined with other thrombectomy techniques in the thrombectomy treatment of patients with acute internal carotid artery occlusion.Methods From January 2016 to November 2019,we retrospectively analyzed 52 patients data from the Department of Neurology,Guangdong Provincial People’s Hospital,those patients were diagnosed as acute internal carotid artery occlusion results from cardiac cerebral embolism and treated with mechanical thrombectomy.They were divided into observation group and control group in according to whether suction treatment in combination with 8F guide catheter was conducted.Data collected and analyzed between the two groups included age,gender,hypertension,diabetes,Alberta Stroke Program Early CT(ASPECT)score,the United States National Institutes of Health Stroke Scale(NIHSS)score,bridging treatment,onset to puncture time(OTP),puncture to recanalization time(PTR),mechanical thrombectomy technique,number of thrombectomy maneuvers,vascular recanalization,asymptomatic intracranial hemorrhage(aSICH),symptomatic intracranial hemorrhage(SICH),mRS at 90 days after endovascular thrombectomy.Results(1)There were no statistically significant differences in baseline data between the two groups of patients(P>0.05).(2)There were no statistically significant differences in bridging treatment,OTP,PTR,mechanical thrombectomy technique,aSICH and SICH between the two groups of patients(P>0.05).The average times of thrombectomy in the observation group and the control group were 2.1 and 3.0 respectively,and the difference between the two groups was statistically significant(P=0.009).In the observation group,23 cases had successful recanalization,17 cases had good mRS prognosis 90 days after operation,and 11 cases in the control group had successful recanalization,and 7 cases had a good prognosis at 90 days after operation.The difference between the two groups was statistically significant(P<0.05).Conclusion For patients with acute internal carotid artery occlusion results from cardiac cerebral embolism,the application of 8F guided catheter suction combined with other thrombectomy techniques can improve the effect of thrombectomy.It is a method of mechanical thrombectomy with clinical value.