TREVO取栓支架在缺血性卒中急性期患者中的初步应用

目的初步探讨采用TREVO支架对缺血性卒中急性期患者取栓的效果。方法回顾性分析北京丰台右安门医院神经介入科2016年4月至6月使用TREVO取栓支架治疗缺血性卒中急性期患者6例,其中大脑中动脉(MCA)闭塞2例(时间窗为2.7~5.5 h),基底动脉闭塞4例(时间窗为4.0~7.0 h),通过改良脑梗死溶栓试验(mTICI)评价取栓效果,采用美国国立卫生研究院卒中量表(NIHSS)评分评价治疗前后患者神经功能的状况,采用改良Rankin量表(mRS)评分评估患者预后。结果 (1)6例患者经1~2次取栓后,其中5例闭塞血管获得再通(mTICIⅡb~Ⅲ级,后循环4例,MCA 1例),1例MCA闭塞部分再通(m TICIⅡa级);(2)2例MCA闭塞患者出院时NIHSS评分较入院时降低8分1例,无改善1例;4例基底动脉闭塞患者中,3例出院时NIHSS评分较入院时降低8~26分,无改善1例;2例MCA闭塞患者出院3个月mRS评分0分1例,4分1例;4例基底动脉出院后3个月mRS评分0分1例,1分2例,5分1例。结论使用TREVO支架取栓治疗缺血性卒中急性期患者的初步经验显示比较安全、有效。

Preliminary application of TREVO device in patients with acute ischemic stroke

Objective To preliminarily discuss the effect of thrombectomy with the TREVO device in patients with acute ischemic stroke.Methods Six patients with acute ischemic stroke treated with TREVO device at the Department of Neurointervention,Beijing Fengtai You′anmen Hospital from April to June 2016 were analyzed retrospectively,including 2 patients with middle cerebral artery (MCA)occlusion (time window from 2. 7 to 5. 5 h),4 with basilar artery occlusion (time window from 4. 0 to 7. 0 h). The effect of thrombectomy was evaluated by the modified thrombolysis in cerebral infarction (mTICI ) scores. The National Institutes of Health Stroke Scale (NIHSS)scores were used to evaluate the neurological status of patients before and after treatment. The prognosis was evaluated by the modified Rankin scale. Results (1 )After 1 to 2 embolectomies,the occlusive arteries of 5 patients achieved recanalization (mTICI gradeⅡb-Ⅲ;posterior circulation in 4 cases,MCA in 1 case). (2)Compared with at admission,the NIHSS score in 1 of 2 patients with MCA occlusion was reduced by 8 points at discharge,and 1 was not any improvement;compared with at admission,the NIHSS scores in 3 of 4 patients with basilar artery occlusion were decreased by 8-26 points at discharge,and 1 was not any improvement;in 2 patients with MCA occlusion,the modified Rankin scale scores were 0 to 1 at 3 months after discharge (0 in 1 case,4 in 1 case);the Rankin scale scores in 4 patients with basilar artery occlusion at 3 months after discharge were 0 in 1 case,1 in 2 cases,and 5 in 1 case.Conclusion The preliminary experience of using TREVO device embolectomy for patients with acute ischemic stroke shows that it is more safe and effective.