RECO支架与Solitaire支架对急性前循环大血管闭塞血管再通的疗效及安全性对比研究

目的 比较急性前循环大血管闭塞性缺血性卒中采用RECO支架与Solitaire支架取栓治疗的有效性及安全性。方法 回顾性分析2019年1月-2020年5月西安交通大学第一附属医院连续收治的行血管内支架取栓治疗的急性前循环大血管闭塞性缺血性卒中患者的临床资料。根据患者选用的支架类型将其分为RECO支架治疗组和Solitaire支架治疗组。比较两组患者的基线资料，治疗有效性指标（血管成功再通率、首次取栓再通率、穿刺至手术结束时间及90 d良好预后率），以及安全性指标（术后24 h症状性颅内出血，术后24 h和90 d的全因死亡率）的差异。结果 最终纳入81例急性前循环大血管闭塞性缺血性卒中患者，平均年龄64.0±12.0岁，男性57例（70.4%）；RECO支架治疗组42例，Solitaire支架治疗组39例。两组患者年龄、性别分布、基线NIHSS评分、ASPECTS评分，高血压、心房颤动、糖尿病、缺血性卒中或TIA病史比例，随机血糖、血小板计数、入院时Hcy、收缩压水平，以及闭塞部位、串联病变、桥接治疗比例和全身麻醉比例差异均无统计学意义。RECO支架治疗组与Solitaire支架治疗组术后血管成功再通率（88.1% vs. 82.1%）、首次取栓再通率（28.6% vs . 38.5%）、穿刺至手术结束时间（95.6±12.3 min vs . 92.5±14.2 mi n）、术中血栓逃逸率（11.9% vs . 15.4%）、夹层样病变发生率（4.8% vs . 2.6%）及术后24 h症状性颅内出血（14.3% vs. 10.3%）、24 h全因死亡率（7.1% vs. 5.1%）、90 d全因死亡率（19.0% vs. 17.9%）及90 d良好预后率（57.1% vs. 46.2%）差异均无统计学意义。结论 RECO支架治疗急性前循环大血管闭塞性缺血性卒中安全有效，其治疗效果及安全性与Solitaire支架无明显差异。

Comparative Efficacy and Safety of RECO Flow Restoration Device versus Solitaire Stent for Acute Large Vessel Occlusion in Anterior Circulation

Objective To compare the efficacy and safety of RECO flow restoration device and Solitaire stentfor acute large vessel occlusion in anterior circulation.Methods This retrospective study enrolled the patients with acute anterior circulation largevessel occlusion stroke who received mechanical thrombectomy with stent retrievers from theFirst Hospital Affiliated to Xi’an Jiaotong University between January 2019 to May 2020, andthe patients were divided into observation group (RECO stent) and control group (Solitaire stent).The baseline data, effectiveness indicators (successful recanalization rate, first-pass recanalizationrate, time from puncture to end of operation, good prognosis at 90 days) and safety indicators(symptomatic intracranial hemorrhage within 24 hours after procedure, all-cause death within 24hours and 90 days) between the two groups were compared.Results A total of 81 patients were enrolled in this study, with a mean age of 64.0±12.0 years and