SWIM技术治疗后循环大血管闭塞所致急性缺血性卒中的有效性和安全性观察

目的 观察SWIM技术治疗后循环大血管闭塞所致急性缺血性卒中的有效性及安全性。方法 回顾性分析2017年2月-2018年11月于大连市中心医院采用SWIM技术治疗的后循环大血管闭塞所致急性缺血性卒中患者的临床资料，评价该技术的疗效和安全性，并分析影响患者预后的因素。观察指标为术后即刻成功再通（mTICI≥2b）、90 d良好预后（mRS评分≤2分），以及术后24 h任何颅内出血、90 d全因死亡。结果 共纳入35例患者，平均年龄66.1±12.1岁，男性26例（74.3%），基线NIHSS评分22（15～34）分。术后即刻成功再通率为94.3%（33/35），90 d良好预后率为45.7%（16/35），24 h颅内出血率为17.1%（6/35），90 d全因死亡率为37.1%（13/35）。单因素分析显示，基线NIHSS评分较低（P =0.001）、基线后循环ASPECTS评分较高（P =0.016）、发病至到院时间较短（P =0.039）、发病至再通时间较短（P =0.047）、血管成功再通率较高（P =0.036）以及饮酒比例较低（P =0.042）与良好预后相关。结论 使用SWIM技术治疗后循环急性缺血性卒中相对安全、有效。

Efficacy and Safety of SWIM Technique for Acute Ischemic Stroke Due to Large Vessel Occlusion in Posterior Circulation

Objective To observe the efficacy and safety of SWIM technique in the treatment of acute ischemic
stroke due to posterior circulation large vessel occlusion.
Methods A retrospective analysis of clinical data of patients with posterior circulation acute
ischemic stroke treated with SWIM technique in the Dalian Central Hospital from February 2017
to November 2018 was undertaken. The outcomes were reperfusion immediately after surgery
(successful reperfusion was defined as mTICI ≥2b), mRS score at 90 days (good prognosis was
defined as mRS score ≤2), and any intracranial hemorrhage within 24 hours after surgery and allcause
death at 90 days.
Results A total of 35 patients were included, with an average age of 66.1±12.1 years, and 26 males
(74.3%), the median baseline NIHSS score was 22 (15-34). The rate of successful recanalization
was 94.3% (33/35), the rate of good prognosis at 90 days was 45.7% (16/35), the rate of intracranial
hemorrhage within 24 hours was 17.1% (6/35), and the all-cause mortality at 90 days was 37.1%
(13/35). Univariate analysis showed that the lower NIHSS score at admission (P =0.001), a higher
pc-ASPECTS score at admission (P =0.016), a shorter time from onset to door (P =0.039), a shorter
time from onset to recanalization (P =0.047), a better reperfusion (P =0.036), and a lower percentage
of drinking (P =0.042) were associated with good prognosis.
Conclusions SWIM technique is relatively safe and effective for patients with posterior circulation
acute ischemic stroke.