抽吸取栓术与抽吸结合支架取栓术治疗脑前循环栓塞疗效比较

Comparison of the efficacy of aspiration thrombectomy and thrombectomy with combined aspiration and stent retriever in the treatment of anterior circulation cerebral embolism

目的比较抽吸取栓术和抽吸结合支架取栓术治疗脑前循环栓塞的疗效和安全性。方法收集广州市番禺区中心医院2020年1月至2022年6月诊断脑前循环栓塞且接受急诊取栓手术治疗的病例,根据取栓方式不同,分为抽吸取栓组(40例)和抽吸结合支架取栓组(64例)。比较两组NIHSS评分、良好预后率(mRS评分≤2分),取栓后血管再通率(mTICI评分≥2b),围手术期并发症等。结果术前较术后、术前较出院NIHSS评分变化,以及出院时、90 d良好预后率,抽吸取栓组显著优于抽吸结合支架取栓组。两组血管再通率、不良事件发生率无显著差异。结论对于前循环脑栓塞患者,抽吸取栓术相较抽吸联合支架取栓术可能具有更好的神经功能缺损改善效果及预后,两者在血管再通率和围手术期并发症发生率方面无显著差异。

Objective To compare the efficacy and safety of aspiration thrombectomy and thrombectomy combined with aspiration and stent retriever for the treatment of anterior circulation cerebral embolism.Methods Patients with anterior circulation cerebral embolism and treated with emergency thrombectomy surgery at Guangzhou Panyu Central Hospital from January 2020 to June 2022 were enrolled in this study.They were divided into two groups based on the thrombectomy method received:an aspiration thrombectomy group(40 cases)and a thrombectomy combined with aspiration and stent retriever group(64 cases).The NIHSS score,good prognosis rate(mRS score≤2),post-thrombectomy vessel recanalization rate(mTICI score≥2b),and perioperative complication rate were compared between the two groups.Results The change of NIHSS score from preoperative to postoperative,the good prognosis rate at the time of discharge and at 90 days after discharge,the thrombectomy group were significantly better than those in the thrombectomy with combined aspiration and stent retriever group.There were no significant differences in the rates of successful vessel recanalization and adverse events between the two groups.Conclusions Compared with the thrombectomy combined with aspiration and stent retriever,aspiration thrombectomy may lead to better improvement in neurological function deficits and good prognosis rates for patients with anterior circulation cerebral embolism.There is no significant difference in the rates of successful vessel recanalization and perioperative complications between the two approaches.