Solumbra血管内再通技术治疗急性大动脉闭塞性脑梗死  

Solumbra thrombectomy as intravascular recanalization for treatment of acute ischemic stroke due to large cerebral artery occlusion

作　　者：张合亮[1] 刘美利[2] 孙刚 郭再玉[1] 张文龙[1] 桂庆红 李博[1] 

机构地区：[1]天津市泰达医院神经外科,300457 [2]天津市泰达医院神经内科,300457

出　　处：《中华老年医学杂志》2018年第2期148-153,共6页Chinese Journal of Geriatrics

基　　金：天津市卫生局科技基金资助项目（2012KZ047）;天津市滨海新区卫生局科技项目（2012BWKY027）;天津市卫生行业重点攻关项目（14KG134）

摘　　要：目的探讨Solumbra血管内再通技术治疗急性大动脉闭塞性脑梗死的可行性、有效性和技术优势。方法回顾性分析2013年1月至2016年8月我院行常规支架取栓（Stent组，21例）和Solumbra技术（Solumbra组，11例）再通治疗的急性脑梗死患者的临床资料，对2组患者特点、手术相关指标和临床结果进行对比分析。结果Stent组与Solumbra组在血栓逃逸率（28．6％和18．2％，P=0．425）、取栓次数[（2．4±1．3）次和（2．2±1．0）次，P=0．657）]、无症状脑出血（14．3％和18．2％，P=0．572）、症状性脑出血（9．5％和18．2％，P=0．427）、有效再通率（TICI2b-3）（81．0％和81．8％，P=0．670）、穿刺到再通时间（PTR）[（51．6±34．5）min和（66．4±39．0）min，P=0．279）]、和术后7dNIHSS评分[（11．3±7．2）分和（11．6±7．7）]分，P=0．925）方面对比差异均无统计学意义。术后90dmRS评分Stent组和Solumbra组对比差异无统计学意义（P=0．490）；功能恢复良好（mRS≤2）率分别为47．6％（10／21）和63．6％（7／11），尽管差异无统计学意义（P=0．314），但数值上Solumbra组有向好的趋势。结论Solumbra血管内再通技术是治疗急性大血管闭塞性脑梗死安全、有效的方法；与传统支架取栓相比，在90d神经功能恢复良好率上具有向好的趋势。Objective To investigate the feasibility, effectiveness, and technical superiority of Solumbra thrombectomy for treatment of acute large cerebral artery occlusion stroke. Methods 32 patients who had acute large cerebral artery occlusion stroke and received mechanical thrombectomy in TEDA Hospital of Tianjin between January 2013 and August 2016, were divided into two groups：stent group （ with conventional stent-retrievers, n= 21 ） and Solumbra group （ with Solumbra thrombectomy, n =11）. Clinical characteristics, variables correlated with operation, and clinical outcomes were compared and analyzed retrospectively. Results There were no differences in basic clinical and radiographic parameters between stent group versus Solumbra group （all P〉0.05）.Moreover, there were no differences between Solumbra group versus Stent group in rates of embolus to new territory（18.2% vs. 28.6%,P=0.425）,in times of thrombectomy（2.2±1.0 vs. 2.4± 1.3,P=0.657）,in non symptomatic intracranial hemorrhage （ 18.2 % vs. 14.3%, P =0. 572 ）, in symptomatic intracranial hemorrhage（18.2% vs. 9.5%,P=0.427）,in TICI 2b/3 revascularization（81.8% vs. 81.0%,P =0. 670）,in puncture-to-reperfusion time[（66.4±39.0）min vs. （51.6±34.5）min,P=0. 279],and in NIHSS at 7 days（11.6 ± 7.7 vs. 11.3 ± 7.2, P = 0. 925）. A modified Rankin Scale（mRS ≤2）is a variable of recovery of function and good clinical outcome at 90 days. The levels of mRS were similar（P = 0. 490）between Solumbra and stent groups, but there was a tendency to higher rate of good clinical outcome at 90 days in Solumbra group （63.6%, 7/11 ） than in stent group （47.6%, 10/21 ） ,Conclusions Solumbra thrombectomy as intravascular revascularization technique is an effective and safe strategy for endovascular recanalization of acute large cerebral artery occlusion stroke. Compared with conventional Stent-Retriever thrombectomy,Solumbra thrombectomy has a good clinical outcome tendency at 90 days after operation.

关 键 词：脑梗死 Solumbra技术 

分 类 号：R743.3[医药卫生—神经病学与精神病学]