Sofia远端通路导管在急性前循环大血管闭塞取栓治疗中的应用

Application of Sofia distal access catheter in the thrombectomy therapy for acute occlusion of great vessels of anterior circulation

目的探究Sofia远端通路导管在急性前循环大血管闭塞取栓治疗中的应用。方法选择2019年6月至2020年6月在本院行介入治疗的急性缺血性脑卒中患者20例为研究对象,依据治疗方式将其分为单纯抽吸组15例与联合治疗组5例。单纯抽吸组男9例,女6例,年龄(67.3±12.8)岁;联合治疗组男3例,女2例,年龄(68.5±14.2)岁。单纯抽吸组在穿刺后仅给予单纯抽吸血栓治疗,联合治疗组在上述治疗反复抽吸不通的情况下联合支架取栓术。评估两组患者股动脉穿刺成功到血管再通的时间、发病到血管再通的时间、血管开通程度、美国国立卫生研究院卒中量表(NIHSS)评分及相关并发症的差异。结果单纯抽吸组和联合治疗组从股动脉穿刺成功到血管再通的时间分别为23(15,37)min和33(29,51)min,单纯抽吸组要比联合治疗组短,差异有统计学意义(Z=-2.783,P=0.013)。术后24 h两组NIHSS评分为10(5,13)分比8(3,9)分(Z=-0.893,P=0.138),术后7 d两组NIHSS评分为7(2,12)分比5(3,7)分(Z=-1.738,P=0.127),较治疗前均有好转,但组间差异均无统计学意义(均P>0.05)。联合治疗组颅内出血和血栓逃逸发生率分别为20.00%(1/5)、0.00%(0/5),单纯抽吸组为20.00%(3/15)、13.33%(2/15),差异均无统计学意义(均P>0.05)。结论相对单纯支架取栓或抽吸联合支架取栓来说,采用Sofia远端通路导管在急性前循环大血管闭塞取栓治疗中具有相似治疗效果和安全性,且该方式具有操作简单、耗时少等特点。

Objective To explore the application of Sofia distal access catheter in the thrombectomy therapy for acute occlusion of great vessels of anterior circulation.Methods Twenty patients with acute ischemic stroke who underwent interventional therapy in our hospital from June 2019 to June 2020 were selected as the research objects.According to the treatment methods,they were divided into a simple suction group and a combined treatment group.In the simple suction group,there were 9 males and 6 females,with an age of(67.3±12.8)years old;in the combined treatment group,there were 3 males and 2 females,with an age of(68.5±14.2)years old.The simple suction group was given only suction of thrombus after an puncture,while the combined treatment group was given stent thrombectomy when the suction was repeatedly blocked.The time from successful femoral artery puncture to vascular recanalization,the time from onset to vascular recanalization,degree of vascular opening,National Institutes of Health Stroke Scale(NIHSS)score,and related complications were assessed in the two groups.Results The time from successful femoral artery puncture to vascular recanalization in the simple suction group was 23(15,37)min,which was shorter than that in the combined treatment group[33(29,51)min],with a statistically significant difference(Z=-2.783,P=0.013).The NIHSS scores of the two groups at postoperative 24 h were 10(5,13)points vs.8(3,9)points(Z=-0.893,P=0.138),and the NIHSS scores of the two groups at postoperative 7 d were 7(2,12)points vs.5(3,7)points(Z=-1.738,P=0.127),which were all better than those before the treatment,but there were no statistically significant differences between the two groups(all P>0.05).The incidences of intracranial hemorrhage and thrombosis escape in the combined treatment group were 20.00%(1/5)and 0.00%(0/5),those in the simple suction group were 20.00%(3/15)and 13.33%(2/15),without statistically significant differences(both P>0.05).Conclusion Compared with simple stent thrombectomy or suction combined with stent thrombectomy,the use of Sofia distal access catheter has similar therapeutic effect and safety in the thrombectomy therapy for acute occlusion of great vessels of anterior circulation,and this method is simple and less time-consuming.