Solitaire~(TM)支架取栓治疗急性基底动脉闭塞研究

目的评估急性基底动脉闭塞患者使用SolitaireTM支架机械取栓的有效性和安全性,分析其临床预后的影响因素。方法回顾性分析本中心连续入组的30例急性基底动脉闭塞患者,均使用SolitaireTM支架设备进行机械取栓治疗分析支架,分析取栓治疗的再通率及并发症,评估治疗90 d临床预后,分析影响临床预后的因素。结果 30例患者均顺利完成机械取栓手术。患者平均年龄为(58.6±8.4)岁,术前美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分中位数25.5分(21.3,29.5),格拉斯哥昏迷量表(Glasgow Coma Scale,GCS)评分中位数8分(6.0,9.8),改良Rankin量表(modified Rankin Scale,m RS)评分中位数5分(5.0,5.0)。成功再通[脑梗死溶栓分级(Thrombolysis in Cerebral Ischemia Scale,TICI)3或2b级]28例(93.3%),6例(20.0%)发生症状性颅内出血,9例(30.0%)患者预后良好(m RS 0~2分)。9例死亡,死亡率为30.0%(9/30)。术前患者意识不清(P=0.014)及m RS评分较高(P=0.020)与不良预后(m RS2分)相关。结论使用SolitaireTM支架进行急性基底动脉闭塞患者的机械取栓,有较高的再通率,能够改善功能性预后。

Mechanical Thrombectomy with the SolitaireTM Device in Acute Basilar Artery Occlusion

Objective To evaluate the efficacy and safety of mechanical thrombectomy with the SolitaireTM device in revascularization of patients with acute basilar artery occlusion (ABAO) and to identify its predictive factors for clinical outcome.
Methods Thirty patients with acute ischemic stroke attributable to ABAO treated with the SolitaireTM device in our center were retrospectively studied. Recanalization rates after stent Retrieval were determined and the clinical outcome and mortality rate were assessed 90 days after treatment. Predictive factors for clinical outcome were analyzed.
Results The mean age of the patients was (58.6±8.4) years, the median prethrombectomy National Institutes of Health Stroke Scale score was 25.5 (21.3, 29.5), the median Glasgow Coma Scale (GCS) score was 8 (6.0, 9.8) and the mean modified Rankin Scale (mRS) score was 5 (5.0, 5.0). Successful recanalization (Thrombolysis in Cerebral Ischemia Scale, TICI 3 or 2b) was achieved in 28 patients (93.3%). Six symptomatic intracranial hemorrhages occurred after procedure. A favorable outcome, defined as a mRS of 0~2, was observed in 30.0% of patients (9/30). Overall mortality rate was 30.0% (9/30). In the univariate analysis, patients with coma (P=0.014) and a higher mRS (mRS>2, P=0.020) on admission was significantly associated with a poor outcome.
Conclusion Mechanical thrombectomy with the SolitaireTM device can rapidly and effectively contribute to a high rate of recanalization and improve functional outcome in patients with ABAO.