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机械血栓切除术在前后循环中风中的失败:来自大体积综合中心的当前结果
Alexander Neumann1, P Schildhauer2, S M Weiler3
1Department of Neuroradiology, University Medical Center Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, Lübeck, 23538, Germany. alexander.neumann@uksh.de.
概括
针对急性缺血性中风 (AIS) 的机械血栓切除术 (MT) 的失败率为10.1%,特别是在远端闭塞方面. 改善支架取回器 (SR) 技术和接入技术是提高再通道成功的关键.
科学领域:
- 神经学 神经学
- 干预性神经辐射学
- 血管外科 血管外科
背景情况:
- 机械血栓切除术 (MT) 是急性缺血性中风 (AIS) 的关键治疗方法.
- 再通道成功并不是普遍的,因为血栓去除和接入路径的挑战有助于MT失败.
- 这项研究调查了在大容量中风中心中MT失败的风险因素.
研究的目的:
- 在急性缺血性中风患者中识别与机械血栓切除术失败相关的风险因素.
- 分析阻塞部位,患者人口统计和程序因素对MT结果的影响.
- 为了评估随着时间的推移,重新道化率的趋势.
主要方法:
- 在2019年至2023年期间进行的552次机械血栓切除术的回顾性分析.
- 评估包括前后循环阻塞,使用直接吸收和/或支架取回器 (SR) 技术.
- MT失败被定义为Cerebral Infarction中修改的血栓溶解得分0或1,分析了患者和程序变量.
主要成果:
- 机械血栓切除术失败发生在10.1%的病例中 (56名患者).
- 远端闭塞的成功率明显较低 (p < 0.01).
- 支架取回器 (SR) 失败,特别是在凯斯马赫分类2B中,是最常见的原因 (48%,p < 0.001),而时间趋势分析显示,再通道化率同比有所改善 (p < 0.01).
结论:
- 机械血栓切除术的失败在AIS治疗中仍然是一个问题,即使在高体积的中心,远端闭塞带来了更大的挑战.
- 支架检索器 (SR) 技术的进步和精细的访问策略对于改善未来的MT结果至关重要.
- 设备技术和程序技术的持续改进有望提高再通道化率和患者的治疗结果.
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