无导丝微导管技术在急性缺血性卒中机械取栓中的应用  

Application of Microcatheter Technique without Guide Wire in Mechanical Thrombectomy of Acute Ischemic Stroke

作　　者：崔焕喜 崔红凯[1] 裴观辉 李道广 孙广普 陈松 王明盛[1] CUI Huanxi;CUI Hongkai;PEI Guanhui;LI Daoguang;SUN Guangpu;CHEN Song;WANG Mingsheng(Department of Neurointerventional Intervention,the First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453100,China)

机构地区：[1]新乡医学院第一附属医院神经介入科,河南新乡453100

出　　处：《河南医学研究》2023年第19期3478-3481,共4页Henan Medical Research

基　　金：河南省医学科技攻关联合共建项目(LHGJ20220629)。

摘　　要：目的探讨无导丝微导管技术在急性大血管闭塞性缺血性卒中机械取栓术中通过血栓的可行性及安全性。方法回顾性分析新乡医学院第一附属医院神经介入科病区2020年7月至2022年7月收治111例急性缺血性卒中机械取栓患者的临床资料,根据通过血栓方式分为对照组(56例)和观察组(55例)。对照组通过血栓使用常规微导丝技术,观察组通过血栓采用无导丝微导管技术,两组患者均接受机械取栓治疗,比较两组首次通过血栓成功率及术中、术后对比剂外渗或蛛网膜下腔出血并发症发生情况。结果观察组一次性通过血栓成功率低于对照组,差异无统计学意义(P>0.05)。观察组术中血管造影蛛网膜下腔出血并发症发生率低于对照组,差异有统计学意义(P<0.05)。观察组术后颅脑CT蛛网膜下腔出血并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论使用无导丝微导管技术通过血栓与常规微导丝技术通过血栓的一次性通过血栓成功率无明显差异,但无导丝微导管技术通过血栓能够减少对比剂外渗及蛛网膜下腔出血的风险,显示出更高的安全性。Objective To investigate the feasibility and safety of microcatheter technique without guide wire in mechanical thrombectomy of acute great vessel occlusive ischemic stroke.Methods The clinical data of 111 patients with acute ischemic stroke treated with mechanical thromposectomy from July 2020 to July 2022 in the Department of Neurointerventional Intervention,the First Affiliated Hospital of Xinxiang Medical College were retrosrectively analyzed,and they were divided into control group(56 cases)and observation group(55 cases)according to the way of thrombi.The control group was treated with conventional microguide wire technique through thrombus,the observation group was treated with microcatheter without guide wire technique through thrombus,and both groups were treated with mechanical thrombus removal.The success rate of first-time thrombus passing and the occurrence of intraoperative and postoperative complications of contrast extravasation or subarachnoid hemorrhage were compared between the two groups.Results The success rate of one-time thrombosis in the observation group was lower than that in the control group,and the difference was not statistically significant(P>0.05).The complication rate of subarachnoid hemorrhage in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The complication rate of postoperative cerebral CT subarachnoid hemorrhage in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion There is no significant difference in the success rate of one-time thrombus passage using the guided microcatheter technique and the conventional guided microcatheter technique,but the guided microcatheter technique can significantly reduce the risk of contrast extravasation and subarachnoid hemorrhage through the thrombus,indicating a higher safety.

关 键 词：急性缺血性卒中 机械取栓 无导丝微导管技术 微导丝 微导管 

分 类 号：R743.3[医药卫生—神经病学与精神病学]