Sofia Plus导管直接推进技术在急性缺血性脑卒中患者血管内治疗中的应用

Application of Sofia Plus catheter direct propulsion technique in endovascular treatment of acute ischemic stroke

目的评价Sofia Plus导管直接推进技术在急性缺血性脑卒中患者血管内治疗中的安全性、有效性。方法回顾性分析2018年1月~2020年12月江汉大学附属湖北省第三人民医院行血管内治疗的急性缺血性脑卒中大血管闭塞患者96例,根据治疗方法分为抽吸组36例(应用无微导丝、微导管引导的Sofia Plus导管直接推进技术行直接抽吸治疗),支架组60例(应用支架取栓治疗)。比较2组穿刺至再通时间、再通成功率、手术并发症及临床预后。结果抽吸组Sofia Plus导管直接推进技术成功率33例(91.7%),无技术并发症。直接抽吸再通成功30例(83.3%),技术失败或抽吸不成功患者进行补救性支架取栓6例(16.7%)。抽吸组与支架组再通成功率比较,差异无统计学意义(P>0.05)。抽吸组穿刺至再通时间明显短于支架组[(25.1±8.5)min vs(79.2±24.4)min,P<0.01],一次再通成功率明显高于支架组(77.8%vs 43.3%,P<0.05)。抽吸组良好预后比例明显高于支架组(66.7%vs 50.0%,P<0.05),并发症发生率明显低于支架组(11.1%vs 23.3%,P<0.05)。2组病死率比较,差异无统计学意义(5.6%vs 6.7%,P>0.05)。结论 Sofia Plus导管直接推进技术在急性缺血性脑卒中血管内治疗是安全、可行的,操作简单,手术时间短且临床疗效好。

Objective To evaluate the safety and efficacy of Sofia Plus catheter direct propulsion technique in endovascular treatment of acute ischemic stroke(AIS).Methods Ninety-six AIS patients with great vessel occlusion who underwent endovascular therapy in our hospital from January 2018 to December 2020 were divided into aspiration group(n=36) and stent group(n=60).The patients in aspiration group underwent direct aspiration therapy using microwire-free or microcatheter-guided Sofia Plus catheter direct propulsion technique and those in stent group received thrombectomy and stenting.The time from puncture to recanalization, success rate of recanalization, complications and clinical outcome were compared between the two groups.Results The recanalization was established in 33 patients(91.7%) of aspiration group using Sofia Plus catheter direct propulsion technique with no complication and in 30 patients(83.3%) of aspiration group using direct aspiration technique while 6 patients(16.7%) of aspiration group underwent thrombectomy and stenting due to the failure of Sofia Plus catheter direct propulsion technique or unsuccessful aspiration.No significant difference was detected in success rate of recanalization between the two groups(P>0.05).The time from puncture to recanalization was significantly shorter while the success rate of recanalization at one time was significantly higher, the rate of good outcome and the incidence of complications were significantly lower in aspiration group than in stent group(25.1±8.5 min vs 79.2±24.4 min, P<0.01;77.8% vs 43.3%,P<0.05;11.1% vs 23.3%,P<0.05).No significant difference was detected in mortality between the two groups(5.6% vs 6.7%,P>0.05).Conclusion Sofia Plus catheter direct propulsion technique is safe, feasible and easy to operate for endovascular treatment of AIS patients with a short operation time and good clinical effect.