基底动脉闭塞的机械血栓切除术:第一线策略的影响作为闭塞水平的函数
Louis Tournier1, Jonathan Cortese1,2, Arturo Consoli3
1Interventional Neuroradiology, NEURI Brain Vascular Center, Bicêtre Hospital, Le Kremlin-Bicêtre, France.
Journal of neurointerventional surgery
|March 27, 2024
概括
接触吸收 (CA) 血栓切除术在基础动脉封闭 (BAO) 方面显示出优异的结果,相比于支架恢复器 (SR) 血栓切除术. CA改善了再通道和临床结果,特别是在近邻BAO病例中.
科学领域:
- 血管内治疗治疗 血管内治疗
- 脑血管疾病 脑血管疾病
- 干预神经病学 干预神经病学
背景情况:
- 回顾性研究表明,接触吸收 (CA) 血栓切除术优于支架检索器 (SR) 血栓切除术,用于基底动脉封闭 (BAO).
- 基于BAO中封闭水平的机械血栓切除策略的影响仍然不清楚.
研究的目的:
- 研究一线机械血栓切除术策略 (CA与SR) 对基底动脉封闭 (BAO) 结果的影响.
- 根据闭塞水平 (近端与远端) 和中风病因学分析结果.
主要方法:
- 来自ETIS注册表的380名BAO患者的回顾性分析 (2016年1月至2022年5月).
- 患者被分为单独的CA或SR (±愿望) 组.
- 通过数字减去血管造影测定阻塞水平;有利的结果定义为90天的mRS 0-3.
主要成果:
- 在全球范围内,CA比SR显示出更高的再通道化率 (94.8% vs. 89.1%) 和更好的临床结果 (mRS 0-3: 52.2% vs. 46.0%).
- 在近端BAO中,SR与较差的临床结果有关 (mRS 0-3:20.9%与37.1%相比),尽管具有相似的回化.
- 在远端BAO中,CA的再通道化率更高 (97.7%vs91.7%),临床结果没有显著差异.
结论:
- 与支架回收器 (SR) 血栓切除术相比,接触吸收 (CA) 血栓切除术在基底动脉封闭 (BAO) 中表现出优异的血管学和临床结果.
- 在中间和远端闭塞中,CA显示出更好的血管检查结果,在近端闭塞中显示出更好的临床结果.
- 在近端BAO中,SR对90天mRS的负面影响独立于再通道化率.
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