BGC近端血流控制联合DAC远端抽吸技术治疗前循环急性缺血性脑卒中的疗效  

Efficacy of BGC proximal blood flow control combined with DAC distal suction technique in treatment of anterior circulation acute ischemic stroke

作　　者：腾国良 李翠 TENG Guoliang;LI Cui(Third Department of Neurology,Xi′an Municipal North Hospital,Xi′an,Shaanxi 710043,China;First Department of Neurology,Xi′an Municipal North Hospital,Xi′an,Shaanxi 710043,China)

机构地区：[1]西安市北方医院神经三科,陕西西安710043 [2]西安市北方医院神经一科,陕西西安710043

出　　处：《检验医学与临床》2024年第1期126-130,共5页Laboratory Medicine and Clinic

摘　　要：目的 研究球囊导引导管(BGC)近端血流控制联合远端通路导管(DAC)抽吸技术治疗前循环急性缺血性脑卒中(AIS)的疗效。方法 将142例前循环AIS患者分为研究组(70例)和常规组(72例),常规组采用Trevo支架行常规血管内机械取栓术(EMT),研究组采用与常规组相同的方法进行Trevo支架置入和释放,并采用BGC近端血流控制联合DAC远端抽吸技术进行治疗,比较两组患者的影像学结局、手术相关指标和临床预后。结果 研究组的完全再灌注率显著高于常规组(71.4%vs. 36.1%,P<0.001),无血栓远端迁移患者比例显著高于常规组(82.9%vs. 58.3%,P=0.001),一次性取栓成功率显著高于常规组(60.0%vs. 30.6%,P<0.001),手术相关性颅内出血发生率显著低于常规组(11.4%vs. 41.7%,P<0.001),术后24 h及14 d的美国国立卫生研究院卒中量表评分均显著低于常规组(P<0.001),术后良好结局率显著高于常规组(P<0.05)。结论 在常规支架EMT基础上,加行BGC近端血流控制联合DAC远端抽吸技术治疗前循环AIS,较单纯使用常规支架EMT更易实现一次性取栓成功,减少了远端血栓迁移,提高完全再灌注率,更有利于在术后短期内改善患者的神经系统症状并获得更满意的功能结局。Objective To study the efficacy of balloon guided catheter(BGC)for proximal blood control combined with distal pathway catheter(DAC)distal suction technique in the treatment of acute ischemic stroke(AIS)in the anterior circulation.Methods A total of 142 patients with anterior circulation AIS were divided into the study group(70 cases)and routine group(72 cases).The routine group adopted the Trevo stent to conduct the endovascular mechanical thrombectomy(EMT)operation,the study group adopted the same method as the routine group to conduct the Trevo stent implantation and release,moreover adopted the BGC proximal blood control combined with DAC distal suction technique.The imaging outcomes,surgery related indicators and clinical prognosis were compared between the two groups.Results The complete reperfusion rate of the study group was significantly higher than that of the routine group(71.4%vs.36.1%,P<0.001),the proportion of the patients with non-thrombotic distal migration was significantly higher than that of the routine group(82.9%vs.58.3%,P=0.001),the success rate of one-time thrombectomy was significantly higher than that of the routine group(60.0%vs.30.6%,P<0.001),the incidence rate of surgery related intracranial hemorrhage was significantly lower than that of the routine group(11.4%vs.41.7%,P<0.001),the NIHSS score at postoperative 24 h and on postoperative 14 d was significantly lower than that of the routine group(P<0.001),and the rate of postoperative good outcomes was significantly higher than that of the routine group(P<0.05).Conclusion On the basis of routine stent EMT operation,the addition of BGC proximal blood flow control combined with DAC distal suction technology for the treatment of anterior circulation AIS is easier to achieve the one-time thrombus removal success than the simple routine stent EMT operation,reduces the distal thrombus migration and improves the complete reperfusion rate,and is more conducive to improve the patient′s neurological symptoms and achieve more satisfactory functi

关 键 词：急性缺血性脑卒中 前循环 球囊导引导管 远端通路导管 近端血流控制 远端抽吸 

分 类 号：R743.3[医药卫生—神经病学与精神病学]