Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospecti...Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospectively collected from 66 patients with acute ischemic stroke admitted to the Department of Neurology of Tongliao Hospital and Xuanwu Hospital from August 2019 to November 2021 within 4.5 hours.According to the different recanalization methods,30 patients were assigned to the direct thrombectomy treatment group,and 36 patients in the bridging treatment group(i.e.,the intravenous thrombolysis bridging mechanical thrombectomy treatment group).The primary outcome measure was the neurological outcome at the onset of 90d.Secondary outcome measures were intraoperative vascular recanalization and reperfusion,and the US National Institute of Health Stroke Scale score at 24 hours after surgery.The primary safety indicators are intracranial hemorrhage,including symptomatic intracranial hemorrhage and non-symptomatic intracranial hemorrhage,and 90d mortality.Results:The direct thrombectomy group had lower body mass index,hypertension and baseline Alberta early computed tomography score than the bridging treatment group,and longer time from onset to visit than the bridging group(206.5(119.5,256.25)min vs.150.5(25.205,212.75)min),the above difference were statistically significant(P<0.05).There were no significant differences in successful vascular reperfusion(93%vs.89%),24 hours postoperative National Institute of Health Stroke Scale score(11(5,18)vs.11(5,20)),intracranial hemorrhage(11%vs.14%),symptomatic intracranial hemorrhage(7%vs.17%),90d mRS0 to 2 points(43%vs.36%)and 90d mortality(23%vs.22%)(P>0.05).Conclusion:Similar clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large vessel occlusive stroke within 4.5 hours of onset,direct thrombectomy can be used as an alternative scheme for acute anterior circulation intracranial large artery occlusive stroke.展开更多
目的研究颅内支撑导管辅助Solitaire支架取栓抽吸技术(SWIM)在急性颅脑大血管闭塞治疗中的效果。方法选取太和县人民医院2020年11月~2022年5月收治的90例急性颅脑大血管闭塞患者,采取随机数字表法分为观察组与对照组,各45例。观察组给予...目的研究颅内支撑导管辅助Solitaire支架取栓抽吸技术(SWIM)在急性颅脑大血管闭塞治疗中的效果。方法选取太和县人民医院2020年11月~2022年5月收治的90例急性颅脑大血管闭塞患者,采取随机数字表法分为观察组与对照组,各45例。观察组给予SWIM取栓术,对照组给予单纯支架取栓术。术后,采用脑梗死溶栓(TICI)治疗分级标准评估血管再通情况;分别于术前及术后1周采用美国国立卫生研究院卒中量表(NIHSS)评估神经缺损情况,Barthel量表评估患者日常生活自理能力;分别于术前及术后1周检测比较两组神经功能指标[神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、S100β蛋白(S100β)]水平;术后随访3个月,采用改良Rankin量表(mRs)评估患者预后,记录两组患者并发症和死亡情况。结果观察组血管再通率(95.56%,4345)明显高于对照组(68.89%,3145),差异有统计学意义(χ^(2)=10.946,P<0.05)。术后1周,观察组NIHSS评分、NSE、S100β水平较对照组低[(5.37±1.09)分vs.(6.24±1.22)分、(6.03±0.92)ng ml vs.(8.18±1.17)ng ml、(0.27±0.07)ng ml vs.(0.35±0.09)ng ml],观察组Barthel评分、BDNF水平较对照组高[(79.06±8.72)分vs.(69.14±8.09)分、(4776.51±508.65)pg ml vs.(4022.39±425.33)pg ml],差异有统计学意义(t=3.567、9.690、4.707、5.594、7.630,P<0.05)。术后3个月,观察组mRs评分低于对照组,差异有统计学意义(χ^(2)=5.344,P<0.05);两组并发症发生率和死亡率近似,差异无统计学意义(χ^(2)=0.549、0.714,P>0.05)。结论SWIM取栓术能够较好恢复急性颅脑大血管闭塞患者的血流灌注,改善其神经缺损,提高其生活自理能力,同时可改善患者预后。展开更多
目的 分析支架联合抽吸取栓术治疗颅内大血管急性闭塞的疗效。方法 选取2020年4月-2022年10月新疆医科大学第一附属医院收治的60例颅内大血管急性闭塞的老年患者为研究对象,以随机抽样法为分为对照组(n=30)及观察组(n=30)。对照组采取...目的 分析支架联合抽吸取栓术治疗颅内大血管急性闭塞的疗效。方法 选取2020年4月-2022年10月新疆医科大学第一附属医院收治的60例颅内大血管急性闭塞的老年患者为研究对象,以随机抽样法为分为对照组(n=30)及观察组(n=30)。对照组采取单一支架取栓术治疗,观察组采取支架联合抽吸取栓术治疗。对比两组动静脉再通时间、取栓次数、术中局部脑氧饱和度及治疗前后神经缺损程度量表(National Institute of Health Stroke Scale, NIHSS)、脑卒中预后量表(Modified Rankin Scale, MRS)波动情况、日常生活能力量表(Activity of Daily Living Scale, ADL)评分波动情况。结果 观察组动静脉再通时间(44.78±4.68)min、(86.31±8.77)min均长于对照组,取栓次数(1.84±0.19)次少于对照组,差异有统计学意义(t=5.957、3.601、14.060,P<0.05)。治疗后观察组NIHSS、MRS评分低于对照组,ADL评分高于对照组,差异有统计学意义(P<0.05)。结论 针对颅内大血管急性闭塞实施支架联合抽吸取栓术可取得较理想的疗效,预后良好且安全性有保障。展开更多
基金supported by Health Science and Technology Project of Inner Mongolia Autonomous Region 2022(202201571).
文摘Background:To compare the safety and effectiveness of direct mechanical thrombectomy and bridging therapy for stroke with acute anterior circulation large vessel occlusion within 4.5 hours of onset.Methods:Retrospectively collected from 66 patients with acute ischemic stroke admitted to the Department of Neurology of Tongliao Hospital and Xuanwu Hospital from August 2019 to November 2021 within 4.5 hours.According to the different recanalization methods,30 patients were assigned to the direct thrombectomy treatment group,and 36 patients in the bridging treatment group(i.e.,the intravenous thrombolysis bridging mechanical thrombectomy treatment group).The primary outcome measure was the neurological outcome at the onset of 90d.Secondary outcome measures were intraoperative vascular recanalization and reperfusion,and the US National Institute of Health Stroke Scale score at 24 hours after surgery.The primary safety indicators are intracranial hemorrhage,including symptomatic intracranial hemorrhage and non-symptomatic intracranial hemorrhage,and 90d mortality.Results:The direct thrombectomy group had lower body mass index,hypertension and baseline Alberta early computed tomography score than the bridging treatment group,and longer time from onset to visit than the bridging group(206.5(119.5,256.25)min vs.150.5(25.205,212.75)min),the above difference were statistically significant(P<0.05).There were no significant differences in successful vascular reperfusion(93%vs.89%),24 hours postoperative National Institute of Health Stroke Scale score(11(5,18)vs.11(5,20)),intracranial hemorrhage(11%vs.14%),symptomatic intracranial hemorrhage(7%vs.17%),90d mRS0 to 2 points(43%vs.36%)and 90d mortality(23%vs.22%)(P>0.05).Conclusion:Similar clinical efficacy and safety of direct mechanical thrombectomy and bridging therapy for acute anterior circulation large vessel occlusive stroke within 4.5 hours of onset,direct thrombectomy can be used as an alternative scheme for acute anterior circulation intracranial large artery occlusive stroke.
文摘目的研究颅内支撑导管辅助Solitaire支架取栓抽吸技术(SWIM)在急性颅脑大血管闭塞治疗中的效果。方法选取太和县人民医院2020年11月~2022年5月收治的90例急性颅脑大血管闭塞患者,采取随机数字表法分为观察组与对照组,各45例。观察组给予SWIM取栓术,对照组给予单纯支架取栓术。术后,采用脑梗死溶栓(TICI)治疗分级标准评估血管再通情况;分别于术前及术后1周采用美国国立卫生研究院卒中量表(NIHSS)评估神经缺损情况,Barthel量表评估患者日常生活自理能力;分别于术前及术后1周检测比较两组神经功能指标[神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)、S100β蛋白(S100β)]水平;术后随访3个月,采用改良Rankin量表(mRs)评估患者预后,记录两组患者并发症和死亡情况。结果观察组血管再通率(95.56%,4345)明显高于对照组(68.89%,3145),差异有统计学意义(χ^(2)=10.946,P<0.05)。术后1周,观察组NIHSS评分、NSE、S100β水平较对照组低[(5.37±1.09)分vs.(6.24±1.22)分、(6.03±0.92)ng ml vs.(8.18±1.17)ng ml、(0.27±0.07)ng ml vs.(0.35±0.09)ng ml],观察组Barthel评分、BDNF水平较对照组高[(79.06±8.72)分vs.(69.14±8.09)分、(4776.51±508.65)pg ml vs.(4022.39±425.33)pg ml],差异有统计学意义(t=3.567、9.690、4.707、5.594、7.630,P<0.05)。术后3个月,观察组mRs评分低于对照组,差异有统计学意义(χ^(2)=5.344,P<0.05);两组并发症发生率和死亡率近似,差异无统计学意义(χ^(2)=0.549、0.714,P>0.05)。结论SWIM取栓术能够较好恢复急性颅脑大血管闭塞患者的血流灌注,改善其神经缺损,提高其生活自理能力,同时可改善患者预后。
文摘目的 分析支架联合抽吸取栓术治疗颅内大血管急性闭塞的疗效。方法 选取2020年4月-2022年10月新疆医科大学第一附属医院收治的60例颅内大血管急性闭塞的老年患者为研究对象,以随机抽样法为分为对照组(n=30)及观察组(n=30)。对照组采取单一支架取栓术治疗,观察组采取支架联合抽吸取栓术治疗。对比两组动静脉再通时间、取栓次数、术中局部脑氧饱和度及治疗前后神经缺损程度量表(National Institute of Health Stroke Scale, NIHSS)、脑卒中预后量表(Modified Rankin Scale, MRS)波动情况、日常生活能力量表(Activity of Daily Living Scale, ADL)评分波动情况。结果 观察组动静脉再通时间(44.78±4.68)min、(86.31±8.77)min均长于对照组,取栓次数(1.84±0.19)次少于对照组,差异有统计学意义(t=5.957、3.601、14.060,P<0.05)。治疗后观察组NIHSS、MRS评分低于对照组,ADL评分高于对照组,差异有统计学意义(P<0.05)。结论 针对颅内大血管急性闭塞实施支架联合抽吸取栓术可取得较理想的疗效,预后良好且安全性有保障。
