支架辅助中间导管半包裹血栓技术在脑血管取栓中的临床效果OA
Clinical effect of stent-assisted intermediate catheter semi-wrap thrombus technique in cerebral vascular thrombectomy
目的 探讨支架辅助中间导管半包裹血栓技术在脑血管取栓中的临床效果.方法 回顾性分析 2022 年 1 月至 2024 年 9 月丰城市人民医院及南昌大学第二附属医院收治的 76 例颅内大血管闭塞患者临床资料,按照手术方法不同分为 A 组(支架辅助中间导管半包裹血栓技术,26 例)、B 组[Solitaire 支架取栓联合 Navien 中间导管近距离负压抽吸技术(SWIM),25 例]和 C组[远端通过导管推越技术(ADVANCE),25 例].比较三组治疗后血运重建情况[改良脑缺血治疗评分(mTICI)评分为 2b 或 3 级的比率]、动脉穿刺到血运重建成功时间,术后各时段的美国国立卫生研究院卒中量表(NIHSS)评分和脑卒中改良Rankin 量表(mRS)评分,术后 6 个月的不良反应发生率.结果 术后即刻脑血管造影显示 A 组血运重建成功的患者比例高于 B、C 组,A 组动脉穿刺到血运重建成功时间短于B、C组,术后即时及1周NIHSS评分低于B、C组,差异有统计学意义(P＜0.05).A组术后 30、90与180 d神经功能恢复良好的占比率高于 B、C 组,差异有统计学意义(P＜0.05).术后 6 个月三组不良反应总发生率比较,差异无统计意义(P＞0.05).结论 运用支架辅助中间导管半包裹血栓技术进行脑血管取栓治疗效果较好,且不劣于常用的 SWIM 及 ADVANCE 技术,值得临床应用及推广.
Objective To explore the clinical effect of stent-assisted intermediate catheter semi-wrap thrombus technique in cerebral vascular thrombectomy.Methods A retrospective analysis was conducted on the clinical data of 76 patients with intracranial large vessel occlusion admitted to Fengcheng People's Hospital and the Second Affiliated Hospital of Nanchang University from January 2022 to September 2024.According to different surgical methods,they were divided into group A(stent-assisted middle catheter semi-wrap thrombectomy technique,26 cases),group B(Solitaire FR/stent with intracranial support catheter for mechanical thrombectomy[SWIM],25 cases),and group C(advancing the DAC over the stent retriever[ADVANCE],25 cases).The post-treatment blood revascularization conditions[the ratio of modified cerebral ischemia treatment score(mTICI)rated as grade 2b or 3]and the time from arterial puncture to successful blood revascularization,the national institute of health stroke scale(NIHSS)score and modified Rankin scale(mRS)score at each postoperative time point,and the incidence of adverse reactions 6 months after surgery were compared among the three groups.Results The immediate postoperative cerebral angiography showed group A had higher proportion of patients with successful blood vessel reconstruction compared to group B and C,the time from arterial puncture to successful blood vessel reconstruction was shorter than that of group B and C,the immediate and 1-week NIHSS scores were lower than those of group B and C,and the differences were statistically significant(P＜0.05).The proportions of patients with good neurological function recovery at 30,90 and 180 days after surgery in group A were higher than those in group B and C,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in the total incidence of adverse reactions among the three groups at 6 months after surgery(P＞0.05).Conclusion The use of the stent-assisted semi-wrap technique for middle cerebral artery catheter thrombectomy has a better therapeutic effect and is not inferior to the commonly used SWIM and ADVANCE techniques.It is worthy of clinical application and promotion.
熊倩倩;杨刚;赖贤良;曾正锋
江西省丰城市人民医院神经内科,江西丰城 331100江西省丰城市人民医院神经内科,江西丰城 331100南昌大学第二附属医院神经外科,江西 南昌 330000江西省丰城市人民医院神经内科,江西丰城 331100
医药卫生
颅内大血管闭塞支架辅助中间导管半包裹血栓技术脑血管取栓应用效果
Intracranial large vessel occlusionAdvanc-ing the DAC over the stent retrieverCerebral vascular thrombectomyApplication effect
《中国当代医药》 2026 (12)
35-38,43,5
江西省卫生健康委科技计划项目(202511205).
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