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中华介入放射学电子杂志 ›› 2020, Vol. 08 ›› Issue (01) : 24 -27. doi: 10.3877/cma.j.issn.2095-5782.2020.01.006

所属专题: 文献

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血栓抽吸(ADAPT)与支架取栓在治疗急性大血管闭塞性脑梗死的比对研究
敖峰1, 贺嘉男1, 刘汉伟1, 周斌1,()   
  1. 1. 519000 广东珠海,中山大学附属第五医院介入医学中心
  • 收稿日期:2020-02-05 出版日期:2020-02-25
  • 通信作者: 周斌

Comparation of a direct aspiration first-pass technique (ADAPT) with stent retrievers (SR) for acute stroke therapy

Feng Ao1, Jianan He1, Hanwei Liu1, Bin Zhou1,()   

  1. 1. Department of Interventional Medicine, the Fifth Affiliated Hospital of Sun Yat-sen University, Guangdong Zhuhai 519000, China
  • Received:2020-02-05 Published:2020-02-25
  • Corresponding author: Bin Zhou
  • About author:
    Corresponding author: Zhou Bin, Email:
引用本文:

敖峰, 贺嘉男, 刘汉伟, 周斌. 血栓抽吸(ADAPT)与支架取栓在治疗急性大血管闭塞性脑梗死的比对研究[J/OL]. 中华介入放射学电子杂志, 2020, 08(01): 24-27.

Feng Ao, Jianan He, Hanwei Liu, Bin Zhou. Comparation of a direct aspiration first-pass technique (ADAPT) with stent retrievers (SR) for acute stroke therapy[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2020, 08(01): 24-27.

目的

回顾性对比分析血栓抽吸与支架取栓在治疗急性前循环大血管闭塞性脑梗死中的有效性与安全性。

方法

回顾性收集2018年6月至2019年10月在我院行急性脑血管病血管内治疗的33例患者资料,其中17例行支架取栓,16例行血栓抽吸,主要观察指标为闭塞血管再通率(mTICI 2b级以上),次要观察指标为血管再通时间(股动脉穿刺到再通时间)、远期良好预后率(3月后mRS评分0~2分)、血栓逃逸率、需补救措施率、出血率、死亡率等,采用t检验对不同手术手术时间的差异进行检验,采用卡方检验对不同手术方式定性结果的差异性进行检验。

结果

两组患者术前的NHISS评分中位数分别为血栓抽吸组(13分,2~23分),取栓组(11分,3~19分),二者之间差异无统计学意义(P>0.01)。血栓抽吸治疗闭塞血管开通率(mTICI 2b级以上)为87.5%(14/16),支架取栓治疗闭塞血管开通率(mTICI 2b级以上)为70.6%(12/7),二者差异无统计学意义(χ2=1.41,P>0.01)。两种手术方式在血管开通时间、远期良好预后率、血栓逃逸率、需补救措施率、出血率及死亡率之间差异均无明显统计学意义。

结论

对比支架取栓,血栓抽吸技术治疗急性缺血性大血管闭塞性脑卒中是有效的和安全的。但仍然需要大样本的研究去进一步验证血栓抽吸技术的疗效性与安全性。

Objective

To compare ADAPT with stent retrievers for efficacy and safety asa front-line endovascular procedure for the treatment of acute ischemic stroke with large intracranial artery occlusion of the anterior circulation.

Methods

The clinical data of 33 patients with large intracranial artery occlusions of the anterior circulation who were treated with mechanical thrombectomy by either ADAPT (16 cases) or the stent(17 cases) in our Hospital form June 2018 to October 2019 were retrospectively analyzed. The primary outcome was complete recanalization (modified TICI 2b to 3); secondary outcomes included recanalization time (time from femoral artery puncture to recanalization), clinical outcomes and complication rates (Long-term favorable prognosis rate (mRS score of 0-2 points after 3 months), thrombus escape rate, remedial action rate, bleeding rate, mortality rate, etc.).

Results

The median baseline NIHSS score was the same for both groups (ADAPT, 13 [interquartile range, 2-23] versus stent, 11 [interquartile range, 3-19]). Recanalization rates (ADAPT, 87.5% versus stent, 70.6%], χ2=1.41, P>0.01) did not differ significantly. Time from groin puncture to recanalization, clinical outcomes and complication rates did not differ significantly between the 2 groups.

Conclusions

Compared with stent retrievers, ADAPT is effective and safe in the treatment of acute ischemic stroke. However, large sample studies are still needed to further verify the efficacy and safety of thrombus aspiration technology.

表1 血栓抽吸组与支架取栓组基本资料
表2 血栓抽吸组与支架取栓组治疗结果对比
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