应用国产RECO取栓支架治疗急性缺血性卒中效果的多中心回顾性研究  

A multi-center retrospective study on the effect of domestic RECO flow restoration device in acute ischemic stroke

作　　者：尹俊洋 宗启言 吴达[2] 吕朋华 丁鸭锁[4] 刘艳[5] 邵祥忠 丁桂兵[7] 程言博 曹洁[1] 彭亚[1] Yin Junyang;Zong Qiyan;Wu Da;Lyu Penghua;Ding Yasuo;Liu Yan;Shao Xiangzhong;Ding Guibing;Cheng Yanbo;Cao Jie;Peng Ya(Department of Neurosurgery,the First People′s Hospital of Changzhou,Changzhou,Jiangsu 213000,China;不详)

机构地区：[1]江苏省常州市第一人民医院神经外科,213000 [2]宜兴市人民医院神经外科 [3]苏北人民医院介入科 [4]泰州市人民医院神经外科 [5]靖江市人民医院神经内科 [6]海安市人民医院神经内科 [7]南京医科大学第二附属医院神经内科 [8]徐州医科大学附属医院神经内科

出　　处：《中国脑血管病杂志》2025年第3期168-177,共10页Chinese Journal of Cerebrovascular Diseases

基　　金：常州市第十一批科技计划项目(CJ20244012)。

摘　　要：目的评估国产RECO取栓支架在真实世界治疗急性缺血性卒中(AIS)的有效性及安全性。方法回顾性连续纳入江苏省8家卒中中心2019年1月至2021年6月使用国产RECO取栓支架治疗的颅内血管闭塞所致AIS患者。收集患者的基线及临床资料,包括年龄、性别、基线改良Rankin量表(mRS)评分、入院时美国国立卫生研究院卒中量表(NIHSS)评分、急性卒中Org 10172治疗试验(TOAST)分型、责任闭塞血管及其所在位置(前循环、后循环)、是否为醒后卒中、既往史(高血压病、糖尿病、高脂血症、心房颤动、冠心病、外周动脉疾病)、吸烟、饮酒。收集患者手术相关指标,包括发病至入院时间、入院至动脉穿刺时间、动脉穿刺至血管再通时间、发病至血管再通时间、术前是否静脉溶栓、是否全身麻醉、术中是否结合抽吸取栓、取栓次数、是否首次再通[1次支架取栓即实现改良脑梗死溶栓(mTICI)分级3级]、术中是否采取补救治疗[包括应用其他支架取栓、动脉内尿激酶溶栓、动脉内应用替罗非班、急诊血管成形术(单纯支架置入术、单纯球囊扩张、球囊扩张+支架置入术)]、术中是否使用球囊导引导管及出院时NIHSS评分。有效性指标包括术后即刻血管成功再通(mTICI分级≥2b级)、术后即刻血管完全再通(mTICI分级3级)和术后90 d预后良好(mRS评分≤2分)。安全性指标包括术后24 h内症状性颅内出血(sICH)、与器械相关的术中并发症(血栓逃逸、医源性夹层、手术部位出血)和术后90 d内全因死亡。根据责任闭塞血管所在位置将所有患者分为前循环闭塞组和后循环闭塞组,对患者治疗的有效性及安全性情况进行分析。结果共纳入应用国产RECO取栓支架行机械取栓治疗的颅内血管闭塞所致AIS患者366例,平均(69±11)岁,80岁及以上患者54例(14.8%),男221例(60.4%),前循环闭塞组296例,后循环闭塞组70例。(1)337例(92.1%)患Objective To investigate the efficacy and safety of domestic RECO flow restoration device in endovascular treatment of acute ischemic stroke(AIS)patients in a real-world setting.Methods From January 2019 to June 2021,consecutive patients with acute intracranial vessel occlusion treated with RECO device from 8 stroke centers in Jiangsu Province were analyzed retrospectively.Baseline and clinical data were collected,including age,gender,baseline modified Rankin scale(mRS)scores,National Institutes of Health stroke scale(NIHSS)score on admission,trial of Org 10172 in acute stroke treatment(TOAST)classification,responsible location of occlusion,wake-up stroke,and medical history(hypertension,diabetes mellitus,hyperlipidemia,atrial fibrillation,coronary heart disease,peripheral arterial disease),smoking,and alcohol consumption.Furthermore,surgical parameters were collected,including time indicators(intervals between symptom onset,admission,puncture and recanalization),preoperative intravenous thrombolysis,general anesthesia,combination of aspiration,number of passes,first pass effect(modified thrombolysis in cerebral infarction[mTICI]grade 3 achieved with s single stent-based thrombectomy),rescue therapy(including thrombectomy with other stents,intra-arterial urokinase thrombolysis,intra-arterial application of tirofiban,emergency angioplasty[stent implantation,balloon dilatation,balloon dilatation combined with stent implantation]),balloon guided catheter and NIHSS score at discharge.The effectiveness indicators included immediate successful recanalization after the operation(mTICI grade≥2b),complete recanalization(mTICI grade 3),and a good prognosis at 90 d after the operation(mRS score≤2).The safety indicators included symptomatic intracranial hemorrhage(sICH)within 24 h after the operation,device-related intraoperative complications(such as thrombus escape,iatrogenic dissection,bleeding at the surgical site),and all-cause mortality within 90 days after the operation.All patients were divided into the anterior

关 键 词：缺血性卒中 多中心研究 RECO支架 有效性 安全性 

分 类 号：R743.3[医药卫生—神经病学与精神病学]