直接抽吸一次性取栓技术联合ACE抽吸导管治疗急性颅内血管闭塞的价值研究  

Study on the Value of ADAPT Technology Combined with ACE Aspiration Catheter in the Treatment of Acute Intracranial Vascular Occlusion

作　　者：简能日 周轩[1] 胡发云[2] Jian Nengri;Zhou Xuan;Hu Fayun(Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, China;Department of Neurology, West China Hospital of Sichuan University, Chengdu 610041, China)

机构地区：[1]四川大学华西医院放射科,成都610041 [2]四川大学华西医院神经内科,成都610041

出　　处：《成都医学院学报》2021年第4期437-440,共4页Journal of Chengdu Medical College

基　　金：国家自然科学基金面上项目(No:81371281);四川省科技厅应用基础研究项目(No:2019YJ0140)。

摘　　要：目的探讨直接抽吸一次性取栓(ADAPT)技术联合ACE抽吸导管(美国Penumbra公司)对急性颅内血管闭塞的有效性和安全性。方法选取四川大学华西医院神经内科2019年5—11月收治行ADAPT联合ACE抽吸导管进行取栓的急性颅内血管闭塞患者46例,记录患者入院时及术后1周的美国国立卫生研究所卒中量表评分(NIHSS),90 d改良RANKIN量表评分(mRs)以及改良脑梗死溶栓试验(mTICI)分级等资料,并对手术前后相关临床资料进行统计学分析。结果43例(93.5%)患者实现闭塞血管再通成功,其中mTICI 3级30例,mTICI 2b级13例;19例(41.3%)患者实现一次再通,8例(17.4%)患者实现两次再通(mTICI≥2b);有16例(34.8%)患者抽吸后再辅以支架取栓实现再通。患者出院时NIHSS评分与术前比较,差异有统计学意义(t=12.305,P<0.001)。术后90 d随访,29例(63.0%)患者预后良好。结论ADAPT技术联合ACE导管在治疗急性颅内大血管闭塞中可获得较高的血管再通率,操作安全简便,临床预后较好。Objective To investigate the efficacy and safety of ADAPT(a direct aspiration first-pass thrombectomy)technology combined with ACE aspiration catheter(Penumbra Company,USA)in the treatment of acute intracranial vascular occlusion.Methods A total of 46 patients with acute intracranial vascular occlusion who were treated with ADAPT combined with ACE aspiration catheter for thrombectomy from May to November 2019 in the Department of Neurology,West China Hospital were selected.The NIHSS(national institutes of health stroke scale)scores at admission and one week after operation,the 90-day mRs(modified Ranking scale)scores,the mTICI(modified thrombolysis in cerebral ischeia)grades were recorded.The relevant clinical data before and after operation were statistically analyzed.Results Forty-three patients(93.5%)achieved successful recanalization of occluded vessels,including 30 patients with grade 3 mTICI and 13 patients with grade 2b mTICI.19 patients(41.3%)achieved recanalization in one operation,and 8 patients(17.4%)achieved recanalization after two operations(mTICI≥2b).16 patients(34.8%)achieved recanalization with stent retriever thrombectomy after aspiration.The NIHSS score at discharge was statistically different from that before surgery(t=12.305,P<0.001).After 90 days of follow-up,29 patients(63.0%)had a good prognosis.Conclusion ADAPT combined with ACE aspiration catheter can obtain high recanalization rate in the treatment of acute intracranial vascular occlusion,with the advantages of safe and simple operation,and good clinical prognosis.

关 键 词：脑梗死 直接抽吸一次性取栓技术 取栓 

分 类 号：R310.31[医药卫生—基础医学]