球囊导引导管或常规导引导管辅助颅内支撑导管联合支架取栓技术治疗急性缺血性卒中的疗效对比分析  

Comparative efficacy of balloon guide catheter and conventional guide catheter-assisted intracranial support catheter combined with stent thrombectomy in the treatment of acute ischemic stroke

作　　者：陈正文 李沛城 陈珑[1] 刘一之[1] 李波[1] 袁晨[1] 侯凯文 Chen Zhengwen;li Peicheng;Chen Long;Liu Yizhi;Li Bo;Yuan Chen;Hou Kaiwven(Department of Interventional Radiology,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医学院介入科,苏州215006

出　　处：《中华神经外科杂志》2022年第12期1220-1225,共6页Chinese Journal of Neurosurgery

摘　　要：目的比较颅内支撑导管联合支架取栓技术治疗前循环急性缺血性卒中时, 采用球囊导引导管(BGC)或常规导引导管(CGC)对治疗结果的影响。方法回顾性分析2017年1月至2021年6月苏州大学附属第一医学院介入科收治的198例前循环急性缺血性卒中患者的临床资料。所有患者均接受颅内支撑导管联合支架取栓技术治疗。根据治疗方法将患者分为BGC组和CGC组, 采用1 ∶1倾向性评分匹配的方法获取均衡性更好的样本后, 比较匹配分组后两组患者的首次完全再通、最终再通、手术时间、栓子逃逸、出血转化、90 d临床预后良好、90 d全因死亡以及并发症的差异。结果 198例患者中, BGC组46例, CGC组152例;匹配后共纳入86例患者, 每组各43例。BGC组和CGC组在闭塞血管首次完全再通率[32.6%(14/43)对比32.6%(14/43);RR=1.00, 95%CI:0.64~1.57]、最终再通率[90.7%(39/43)对比90.7%(39/43);RR=1.00, 95%CI:0.48~2.07]、手术时间[(100.3±3.4)min对比(100.5±6.9)min]、栓子逃逸率[9.3%(4/43)对比7.0%(3/43);RR=1.18, 95%CI:0.49~2.86]、出血转化率[18.6%(8/43)对比16.3%(7/43);RR=1.09, 95%CI:0.60~1.96]、90 d临床预后良好率[55.8%(24/43)对比41.9%(18/43);RR=1.48, 95%CI:0.93~2.34]、90 d全因死亡率[20.9%(9/43)对比9.3%(4/43);RR=1.74, 95%CI:0.75~4.03]、并发症发生率[7.0%(3/43)对比4.7%(2/43);RR=1.27, 95%CI:0.42~3.78]的差异均无统计学意义(均P>0.05)。结论对于前循环急性缺血性卒中患者, 当采用颅内支撑导管联合支架取栓技术作为一线治疗方式时, 应用BGC与CGC在治疗效果上无明显差异。Objective To compare the effects of balloon guide catheter(BGC)and conventional guide catheter(CGC)on treatment outcomes in patients with anterior circulation acute ischemic stroke treated with intracranial support catheter combined with stent thrombectomy(SWIM)technique.Methods The clinical data of 198 patients with anterior circulation acute ischemic stroke admitted to the Interventional Radiology Department of the First Affiliated Hospital of Soochow University from January 2017 to June 2021 were retrospectively analyzed.All patients were treated with SWIM technology.The patients were divided into BCC group and CGC group according to the type of guiding catheter used.After obtaining well balanced samples by the 1:1 propensity matching method,the differences in first complete recanalization,final recanalization,the procedure time,embolus escape,hemorrhagic transformation,90-day clinical favorable outcome,90-day all-cause mortality and complications were analyzed between the two groups were compared.Results Among 198 patients,BCC group had 46 patients,CGC group had 152 patients and 86 matched pairs could be identified.No statistical difference was found in first complete recanalization[32.6%(14/43)us.32.6%(14/43),matched RR=1.00,95%CI:0.64-1.57],final recanalization[90.7%(39/43)rs.90.7%(39/43),matched RR=1.00,95%CI:0.48-2.07],the procedure time(100.3±3.4 minus.100.5±6.9 min,P=0.984),embolus escape rate[9.3%(4/43)vs.7.0%(3/43),matched RR=1.18,95%CI:0.49-2.86],hemorrhagic transformation rate[18.6%(8/43)vs.16.3%(7/43),matched RR=1.09,95%CI:0.60-1.96],90-day favorable outcome rate[55.8%(24/43)vs.41.9%(18/43),matched RR=1.48,95%CI:0.93-2.34],90-day all-cause mortality rate[20.9%(9/43)us.9.3%(4/43),matched RR=1.74,95%CI:0.75-4.03],complications rate[7.0%(3/43)us.4.7%(2/43),matched RR=1.27,95%CI:0.42-3.78]between two groups(all P>0.05).Conclusion For patients with anterior circulation acute ischemic stroke,when the technique of SWIM is used as the first-line treatment,there seems no significant difference in the ther

关 键 词：卒中 血管内操作 治疗结果 颅内支撑导管联合支架取栓 球囊导引导管 对比研究 

分 类 号：R743.3[医药卫生—神经病学与精神病学]