急性缺血性脑卒中血管内治疗的临床研究进展

Advances in clinical research on endovascular treatment of acute ischemic stroke

急性缺血性脑卒中发病率和致残率高,及早恢复血流有助于改善患者的预后,机械取栓因其时间窗相对宽以及血管再通率高而备受关注。机械取栓在医疗器械上经历了从MERCI取栓系统到Solitaire FR支架、Revive SE取栓器、3D支架取栓器和Penumbra系统等的改进,取栓成功率和90 d良好预后率(改良Ranking评分低于2分)逐渐得到提高。对取栓治疗失败的补救措施进行研究。而且对特殊人群(醒后卒中、儿童、高龄、妊娠)脑卒中的取栓应用也有成功使用的研究报道。总之,机械取栓能够有效开通急性闭塞的脑部大血管,从而及时恢复急性缺血脑组织的血液供应,达到改善急性缺血性脑卒中患者预后的效果。随着取栓医疗器械和技术的不断进步,效果越来越好。

Acute ischemic stroke has a high incidence rate and a high disability rate,and early recovery of blood flow can improve patients’prognosis.Mechanical thrombectomy has attracted significant attention due to its relatively wide time window and high revascularization rate.Mechanical thrombectomy has been advancing in its medical devices such as MERCI Retriever,Solitaire FR stent,Revive SE Thrombectomy Device,3-Dimensional Stent Retriever,and Penumbra System,with gradually increasing success rate of thrombectomy and rate of favorable outcomes(modified Rankin Scale<2)at 90 days.Research on the rescue measures for thrombectomy failure was performed.There were study reports on successful application of thrombectomy for treatment of stroke in special populations such as patients with wake-up stroke,children,and pregnant women.In conclusion,mechanical thrombectomy can effectively revascularize acutely occluded main cerebral arteries,timely recover the blood supply for the acute ischemic brain tissue,and improve the prognosis of patients with acute ischemic stroke.With the continuous advancement in the medical devices and technologies used in thrombectomy,the therapeutic effect is becoming increasingly better.