直接吸入作为急性内内 Carotid 动脉封闭的第一线技术:初步结果
Miguel Ramírez-Torres1, Blanca Fuentes2,3, Andrés Fernández-Prieto3,4
1Department of Radiology, La Paz University Hospital, Madrid, Spain.
Neurointervention
|January 28, 2026
概括
直接吸入第一次通道技术 (ADAPT) 为急性内内动脉封闭提供更快的再通道. 这种机械血栓切除方法可以改善中风患者的长期功能结果.
科学领域:
- 神经学 神经学
- 干预神经病学 干预神经病学
- 血管神经学 血管神经学
背景情况:
- 急性内内动脉 (ICA) 阻塞是由于高血栓负担和患者的不良后果而面临的重大挑战.
- 机械血栓切除术 (MT) 是主要的治疗方法,但最佳的第一线策略,包括直接吸血第一通技术 (ADAPT) 和支架取回器 (SR) 技术,仍在争论中.
研究的目的:
- 为了比较ADAPT与非ADAPT (单独SR或组合吸血-血栓切除术) 策略的有效性,作为急性内ICA闭塞的第一线治疗.
- 为了评估手术效率,再通道化率和在接受MT治疗ICA闭塞的患者的功能结果.
主要方法:
- 在2019年1月至2024年8月期间在综合性中风中心治疗的85名内ICA闭塞患者的回顾性分析.
- 患者被分为ADAPT和非ADAPT组,在24小时后使用国家卫生研究院中风量表 (NIHSS) 评估结果,并在3个月后使用修改的兰金量表 (mRS) 评估结果.
- 良好的功能结果被定义为mRS分数0-2.
主要成果:
- 在70.6%的患者 (n=60) 中使用了ADAPT,在29.4%的患者 (n=25) 中使用了非ADAPT.
- ADAPT显著缩短了手术时间 (32分钟 vs. 60分钟,P=0.001),并提高了成功再通道化率 (mTICI 2c-3:75% vs. 52%,P=0.038).
- 用ADAPT治疗的患者在3个月后表现出更好的功能结果 (mRS ≤2: 47%与22%,P=0.039). 排放时的NIHSS是良好的功能结果的唯一显著预测因素.
结论:
- 与非ADAPT技术相比,ADAPT已成为内ICA闭塞的优越一线机械血栓切除策略.
- 适应促进了更快的再通道化,并与改善的长期功能结果有关.
- 进一步的研究可能会巩固ADAPT在优化中风治疗方案中的作用.
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