Kobayashi Adam, Czepiel Wojciech, Dowzenko Anatol, Członkowska Anna
II Klinika Neurologii, Instytut Psychiatrii i Neurologii w Warszawie, ul. Sobieskiego 9, 02-957 Warszawa.
Neurol Neurochir Pol. 2008 Sep-Oct;42(5):451-7.
Intravenous thrombolysis is the only approved treatment for acute ischaemic stroke administered within 3 hours of onset. Mechanical embolectomy with the MERCI device is a new treatment option for patients with occlusion of a large cerebral artery who do not meet the current license criteria for thrombolysis, are admitted up to 15 hours from onset, or do not respond to treatment with recombinant tissue plasminogen activator (rt-PA). This is a report of the first two cases of acute ischaemic stroke treated with the MERCI device at our department. One did not meet the inclusion criteria for systemic thrombolysis, and the second did not improve despite rt-PA treatment. In both cases improvement of flow in the MCA was achieved and moderate neurological improvement was observed at 3-month follow-up. More studies and controlled trials are needed to establish the utility of mechanical embolectomy in the treatment of stroke.
静脉溶栓是急性缺血性卒中发病3小时内唯一获批的治疗方法。使用MERCI装置进行机械取栓术是一种新的治疗选择,适用于那些不符合当前溶栓许可标准、发病15小时内入院或对重组组织型纤溶酶原激活剂(rt-PA)治疗无反应的大脑中动脉闭塞患者。这是我们科室首例使用MERCI装置治疗急性缺血性卒中的两例报告。一例不符合全身溶栓的纳入标准,另一例尽管接受了rt-PA治疗但无改善。两例均实现了大脑中动脉血流改善,且在3个月随访时观察到中度神经功能改善。需要更多研究和对照试验来确定机械取栓术在卒中治疗中的效用。