急性前循环大血管闭塞支架取栓“无效再通”相关因素分析

目的探讨急性前循环大血管闭塞应用支架取栓后，出现"无效再通"的相关因素。方法选取急性前循环大血管闭塞经支架取栓后责任血管成功再通的病人56例，分为"有效再通"及"无效再通"2组，分析2组病人的相关影响因素。结果2组发病到血管再通时间（OTR）、穿刺到血管再通时间、ASPECT评分、拉栓次数差异均有统计学意义（P < 0.05~P < 0.01），缩短OTR可以显著减少无效再通的发生率，ASPECT ≤ 7分的病人支架取栓后，无效再通率显著高于>7分的病人，拉栓次数对于无效再通率有显著影响，拉栓≥ 5次的无效再通率显著高于拉栓 < 5次；不同的取栓次数OTR和穿刺到血管再通时间差异有统计学意义（P < 0.01）。结论缩短院前及院内对于缺血性脑血管病的救治流程，开辟绿色通道，熟练取栓技术减少取栓次数，缩短血管再通的时间，可以减少"无效再通"。

Analysis of the related factors of "invalid recanalization" of stent thrombectomy in acute anterior great vessel occlusion

ObjectiveTo investigate the related factors of "ineffective recanalization" after stent thrombectomy in acute anterior great vessel occlusion.MethodsThe responsible vessels in 56 acute anterior great vessel occlusion patients were successfully recanalized after the stent was removed, and the patients were divided into the valid recanalization group and invalid recanalization group.The related factors in two groups were analyzed.ResultsThe differences of the onset to recanalization time(OTR), pnucture to recanalization time(PTR), ASPECT score and number of pulling stent between two groups were statistically significant(P < 0.05 to P < 0.01).Shortening OTR could significantly reduce the incidence of ineffective recanalization.After the bolt in the patients with ASPECT ≤ 7 scores were removed, the ineffective rate of which was significantly higher than that in patients with ASPECT >7 scores.The effect of number of pulling stent on the invalid recanalization rate was significant, the invalid recanalization rate in patients with pulling stent ≥ 5 times was significantly higher than that in patients with pulling stent < 5 times.The differences of the number of pulling stent and PTR between two groups were statistically significant(P < 0.01).ConclusionsShortening the treatment process of ischemic cerebrovascular disease before and in hospital, opening up green channel, skillfully taking stent technique to reduce the times of pulling stent and shortening the time of recanalization of blood vessel can reduce the invalid recanalization.