Neuroscience Institute, Christian Doppler Clinic, Paracelsus Medical University, Ignaz-Harrer-Straße 79, Salzburg A-5020, Austria.
Br J Radiol. 2010 Dec;83(996):1017-22. doi: 10.1259/bjr/42972759.
We report our initial experience with a Solitaire AB neurovascular remodeling stent device in performing cerebral embolectomy in seven patients presenting to our institution with acute stroke who were resistant to iv thrombolytic drug treatment. The main inclusion criteria were: National Institutes of Health Stroke Scale (NIHSS) score ≥10; treatment performed within 8 h from the onset of symptoms and no large hypodensity on CT; and occlusion of a major cerebral artery on the CT angiogram. An admission and a post-interventional NIHSS score were calculated for all patients by two different neurologists. Efficacy was assessed radiologically by post-treatment thrombolysis in myocardial infarction (TIMI) scores and clinically by a 30-day Modified Rankin Scale (MRS) score. The mean duration of neurointerventional treatment was 84 min. All interventions were successful, with TIMI scores of 2 or 3 achieved in 100% of patients. There was one procedural complication in our series owing to a self-detached stent and one patient had a small asymptomatic basal ganglia haemorrhage. There was improvement of more than 4 points on the NIHSS score in 5 (72%) of the patients following treatment, of whom 4 (57%) had a 30-day MRS score of ≤2. The use of a Solitaire stent in acute stroke was safe, time-efficient and encouraging; however, a larger sample size will be required to further evaluate the use of this device, which could benefit a significant number of stroke patients.
我们报告了我们在七名因急性中风而到我院就诊的患者中使用 Solitaire AB 神经血管重塑支架进行脑取栓术的初步经验，这些患者对静脉溶栓药物治疗有抗性。主要纳入标准为：国立卫生研究院卒中量表（NIHSS）评分≥10；在症状发作后 8 小时内进行治疗，且 CT 上无大面积低密影；CT 血管造影显示主要大脑动脉闭塞。两名不同的神经科医生为所有患者计算了入院时和介入后的 NIHSS 评分。通过治疗后的溶栓治疗心肌梗死（TIMI）评分和 30 天改良 Rankin 量表（MRS）评分进行影像学和临床疗效评估。神经介入治疗的平均持续时间为 84 分钟。所有干预均成功，100%的患者达到 TIMI 评分 2 或 3。我们的系列中发生了一例因支架自脱落引起的手术并发症，一例患者出现无症状性基底节区脑出血。治疗后，5 名（72%）患者 NIHSS 评分提高了 4 分以上，其中 4 名（57%）患者 30 天 MRS 评分≤2。急性中风中使用 Solitaire 支架是安全、高效且令人鼓舞的；然而，需要更大的样本量来进一步评估该设备的使用，这可能使大量中风患者受益。
