5F Navien作为远端通路导管在急性缺血性脑卒中取栓中的应用  

Application of 5F Navier as distal access catheter in thrombectomy for acute ischemic stroke

作　　者：韩玉庆[1] 许阳阳[1] 张涛 董力庆 赵理乐[1] HAN Yu-qing;XU Yang-yang;ZHANG Tao(Department of Neurosurgery,Tianjin Xiqing Hospital,Tianjin 300380,China)

机构地区：[1]天津市西青医院神经外科

出　　处：《临床神经外科杂志》2019年第3期250-253,258,共5页Journal of Clinical Neurosurgery

基　　金：天津市西青医院科研基金(xqyyky201805)

摘　　要：目的探讨应用远端通路导管在颅内闭塞大血管动脉取栓治疗中的效果。方法回顾性分析天津市西青医院2015年1月—2017年12月收治68例颅内大动脉闭塞导致急性缺血性脑卒中采用静脉溶栓桥接动脉取栓治疗患者的临床资料。对照组42例患者应用单纯Solitaire AB支架拉栓,观察组26例患者应用5F Navien导管抽吸配合Solitaire AB支架保护技术;对比分析两组患者大血管开通情况。结果68例患者中,颈内动脉颅内段动脉闭塞18例,大脑中脉闭塞34例,基底动脉闭塞16例。入院美国国立卫生研究院卒中量表(National Institutes of Health stroke scale,NIHSS)评分:对照组为(15.07±2.79)分,观察组为(15.31±3.16)分,差异无统计学意义(t=0.323,P=0.748)。导引导管到位时间:对照组为(11.17±3.62)min,观察组为(10.54±4.24)min,差异无统计学意义(t=0.652,P=0.517)。血管获得再通时间:对照组为(104.26±14.28)min,观察组为(85.73±12.06)min,差异具有统计学意义(t=5.509,P<0.001)。术后TICI评分2b/3级者,对照组为24例(57.1%),观察组为21例(80.8%),差异具有统计学意义(χ^2=4.005,P<0.05)。结论在急性缺血性脑卒中取栓治疗中,应用远端通路导管配合支架保护技术可缩短血管再通时间,增加血管再通率。Objective To investigate the application of distal access catheter in the treatment of intracranial occlusion of large artery thrombectomy.Method The clinical data of 68 patients with acute ischemic stroke caused by intracranial arterial occlusion treated in Tianjin Xiqing Hospital from January 2015 to December 2017 were analyzed retrospectively.42 patients in the control group were treated with solitaire AB stent and 26 patients in the observation group were treated with 5F Navier catheter aspiration combined with solitaire AB stent protection technology.The opening of large vessels in the two groups were compared and analyzed.Results Of 68 patients,18 had internal carotid artery occlusion,34 had middle cerebral artery occlusion and 16 had basilar artery occlusion.NIHSS score on admission showed(15.07±2.79)in the control group and(15.31±3.16)in the observation group,there was no significant difference(t=0.323,P=0.748).The time of catheter placement was(11.17±3.62)min in the control group and(10.54±4.24)min in the observation group,with no significant difference(t=0.652,P=0.517).The recanalization time of blood vessel was(104.26±14.28)min in the control group and(85.73±12.06)min in the observation group.The difference was statistically significant(t=5.509,P<0.001).The postoperative TICI score level 2b/3 control group 24(57.1%),observation group 21(80.8%),the difference was statistically significant(χ^2=4.005,P<0.05).Conclusion The application of distal access catheter combined with stent protection in thrombectomy for acute ischemic stroke can shorten the recanalization time and increase the recanalization rate.

关 键 词：急性缺血性脑卒中 远端通路导管 介入治疗 

分 类 号：R743.33[医药卫生—神经病学与精神病学]