Solitaire AB支架取栓术治疗急性脑血管闭塞  

Thrombectomy with Solitaire AB stent in treatment of acute cerebral artery occlusion

作　　者：苏治国[1] 史万超[1] 胡金明[1] 李罡[1] 马晨[1] 王秀菊[1] 宋迎[1] 刘振林[1] 

机构地区：[1]天津市第五中心医院脑科中心,300450

出　　处：《中华神经外科杂志》2014年第6期613-616,共4页Chinese Journal of Neurosurgery

基　　金：天津市滨海新区卫生局一般扶持项目（2012BWKY001）;天津市滨海新区卫生局联合攻关项目（2012BWKL001）

摘　　要：目的探讨采用Solitaire AB支架机械中取栓术治疗急性脑血管闭塞的疗效。方法回顾性分析2010年10月至2012年3月天津市第五中心医院医院神经外科采用SolitaireAB支架机械取栓术治疗急性脑血管闭塞96例患者的临床资料。结果59例获取栓成功，血管完全再通，26例取栓后局部狭窄严重行支架成形后6例完全再通，11例取栓开通血管失败，再通患者中65例达到完全再通T1CI评分3分，20例TICI评分2b。16例患者发生术后出血，15例为小量渗血，1例为中等量出血；本组随访58例患者结果显示术前NIHSS评分（11．34±5．48）与术后1周NIHSS评分（6．87±4．56）比较，差异有统计学意义（P〈0．05）。随访临床结局预后良好患者46例（mRS〈2）。结论Solitaire AB支架取栓术治疗急性脑血管闭塞是安全、有效的，提高了开通率，减少甚至不用溶栓药物，降低了出血并发症。Objective To investigate the effect of mechanical thrombeetomy with Solitaire AB stent in the treatment of acute cerebral artery occlusion. Methods The clinical data of 96 patients with acute cerebral artery occlusion（ onset time 〈 6 hours）treated by mechanical thrombectomy with Solitaire AB stent in the department of neurosurgery of the fifth central hospital of Tianjin from Octobe 2010 to March 2012 were analyzed retrospectively. Results Thrombectomy with Solitaire stent was successful in 59 patients with complete revascularization. 26 patients with partial stenosis after thrombectomy were treated with stenting and 6 patients were completed revascularized. 11 patients were failed in the treatment of thrombectomy. 65 patients were completed revascularized and achieved TICI scored 3 in all of successful cases. 20 patients achieved TICI scores 2b. Intracranial hemorrhage on follow - up CT was noted in 16. 7% （ 16 of 96） of patients. 15 patients suffered slight hemorrhage and there was 1 moderate hemorrhage case. The National Institutes of Health Stroke Scale （NIHSS） score was 6. 87 ± 4. 56 at one week after procedure compared to 11.34 ± 5.48 before procedure. There was significant difference （ P 〈 0. 05 ）. The follow -up modified Rankin Scale （mRS） was less than 2 in 46 cases. Conclusions The application of Solitaire stent in acute stroke was safe and time - efficient, which could improve the recanalization rate, decrease or even avoid the application of thrombolytic drugs and reduce the rate of intracranial hemorrhage.

关 键 词：急性缺血性卒中 机械取栓 SOLITAIRE AB支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]