急性缺血性脑卒中治疗中机械取栓术的发展

Development of Mechanical Thrombectomy in the Treatment of Acute Ischemic Stroke

血栓导致的急性缺血性卒中是一种常见而凶险的脑血管疾病。早期血管开通是其治疗中的重要环节。临床治疗该病的方法包括静脉溶栓、动脉溶栓、血管成形术和机械取栓,而机械除栓是其中最有效的方法。机械除栓术从第一代发展至第三代,大幅提高了患者的治疗效果,但是使用中还存在技术问题包括易造成次级血栓碎块脱落并堵塞下游血管。新一代直接抽吸除栓术可以有效减少次级血栓碎块,而且不涉及复杂机械结构,相比于前几代机械除栓术具有除栓效率高、安全性好、花费低等优势。假以时日,直接抽吸除栓术将发展成为急性缺血性卒中治疗的首要选择。

Acute ischemic stroke is a common and lethal cerebrovascular disease. Early intervention is crucial to the patient treatment and recovery. Clinical treatment options for AIS include intravenous thrombolysis, intraarterial thrombolysis, angioplasty, and mechanical thrombectomy. Currently the most commonly used intervention technique is the mechanical thrombectomy. This treatment has the complication of causing thrombus fragmentation and blockage of distant smaller arteries. In recent years direct aspiration thrombectomy has been proposed as a new thrombus removing technique which can effectively avoid the thrombus fragmentation. Besides, aspiration thrombectomy involves no complex mechanical mechanism, and compared with the mechanical thrombectomy of previous generations, it is more efficient in thrombus elimination, safer, and costs less. Given time for further development, direct aspiration thrombectomy will become the first choice in the treatment of acute ischemic stroke.