上海交通大学学报(医学版) ›› 2017, Vol. 37 ›› Issue (6): 803-.doi: 10.3969/j.issn.1674-8115.2017.06.016

• 论著(临床研究) • 上一篇    下一篇

比较 2 种微导丝对脑卒中支架取栓速度及安全性的影响

史妍慧,刘译升,赵蓉,李格飞,吴依兰,潘辉,唐学梅,孙姬,史楠,刘建仁   

  1. 上海交通大学 医学院附属第九人民医院神经内科,上海 200011
  • 出版日期:2017-06-28 发布日期:2017-07-05
  • 通讯作者: ?刘建仁,电子信箱:liujr021@vip.163.com。史楠,电子信箱:jysjnk001@qq.com
  • 作者简介:史妍慧(1995—),女,硕士生;电子信箱:shililymoon@163.com
  • 基金资助:

    上海市教育委员会高峰高原学科建设计划(20161422);上海交通大学医学院临床研究项目(DLY201614);上海市 “科技创新行动计划”生物医药 领域科技支撑项目(16411953100)

Comparison of impacts on efficiency and safety between two types of microwires during mechanical thrombectomy for stroke

SHI Yan-hui, LIU Yi-sheng, ZHAO Rong, LI Ge-fei, WU Yi-lan, PAN Hui, TANG Xue-mei, SUN Ji, SHI Nan, LIU Jian-ren   

  1. Department of Neurology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
  • Online:2017-06-28 Published:2017-07-05
  • Supported by:

    Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support, 20161422; Clinical Research Project from Shanghai Jiao Tong University School of Medicine, DLY201614; Biomedicine Key Program from Shanghai Municipal Science and Technology Commission, 16411953100

摘要:

目的 · 比较0.014 in 的 Synchro 微导丝和Transend 微导丝对急性缺血性脑卒中支架取栓的速度及安全性的影响。方法 · 入 组 2012 年 10 月至2017 年 1 月在上海交通大学医学院附属第九人民医院接受机械取栓的急性缺血性卒中患者46 例,分为Synchro 组(21 例)和Transend 组(25 例),比较2 组手术操作时间及安全性等指标。结果· 2 组闭塞血管再通率类似(P=0.600),但 Synchro 组从股动脉穿刺至血管再通时间显著短于 Transend 组(48.88 min vs 82.33 min,P=0.001)。2 组患者术后 3 个月获得功能独立 (mRS ≤ 2)的比例类似(P=1.000),操作后蛛网膜下腔出血发生率类似(P=1.000)。但 Transend 组有2 例因血管穿孔导致严重蛛网 膜下腔出血伴血肿,均死亡;Synchro 组仅有 1 例轻微的单纯蛛网膜下腔出血,恢复良好。结论 · 和 Transend 微导丝相比,Synchro 微 导丝能够缩短支架取栓操作时间,致命性蛛网膜下腔出血风险较小。

关键词: 支架取栓, Synchro 微导丝, Transend 微导丝, 急性缺血性卒中, 操作后蛛网膜下腔出血, 颅内动脉穿孔

Abstract:

 Objective · To compare the impacts on clinical efficiency and safety between 0.014 inch Synchro microwire and Transend microwire used during mechanical thrombectomy for acute ischemic stroke (AIS) caused by large artery occlusion.  Methods · Forty-six patients undergoing mechanical thrombectomy with stent retrievers between October 2012 and January 2016 were included, who were classified into Synchro group (21 cases) and Transend group (25 cases). The clinical outcome, procedure time, and safety were analyzed and compared between two groups.  Results · The recanalization rates were similar between two groups (P=0.600) , but time from puncture to vascular recanalization of Synchro group was much shorter than that of Transend goup (48.88 min vs 82.33 min, P=0.001). The rates of functional independence (modified Rankin scale score ≤ 2) were similar between two groups (P=1.000). There was no significant difference of the rates of post-procedure subarachnoid hemorrhage (PSAH) between two groups (P=1.000). However, there were two cases that had fatal subarachnoid hemorrhage with intracranial hematoma in Transend group, while there was only one case of mild subarachnoid hemorrhage who recovered well in Synchro group.  Conclusion · Compared with Transend microwire, Synchro microwire can significantly shorten the procedure time of mechanical thrombectomy, and the risk of fatal subarachnoid hemorrhage is rather small.

Key words:  mechanical thrombectomy, Synchro microwire, Transend microwire, acute ischemic stroke, post-procedure subarachnoid hemorrhage, intracranial artery perforation