Department of Neuroradiology, Neurocenter, University Hospital Freiburg, Germany.
J Neuroradiol. 2011 Mar;38(1):47-52. doi: 10.1016/j.neurad.2010.09.001. Epub 2011 Jan 20.
The aim of this study was to assess the clinical outcome of patients treated with the Penumbra system (PS) for acute ischemic stroke. A retrospective, monocentric matched-pair analysis in comparison with patients treated by intraarterial thrombolysis (IAT) with alteplase was designed for this purpose.
Twenty-two consecutive patients, (mean age 62), with acute ischemic stroke and National Institutes of Health Stroke Scale (NIHSS) scores ≥ 7 were treated with the PS. Twenty corresponding patients could be identified, treated with IAT. Matches were sought for initial NIHSS score and target vessels. Thrombolysis in myocardial infarction (TIMI) grades, mortality rates, NIHSS upon discharge, and modified Rankin scores (mRs) at 90 days were compared.
A total of 32 vessels in 20 patients were treated in either arm of the study. Recanalization to TIMI 2/3 was successful in 25/32 (78%) of target vessels with the PS, and 17/32 (53%) of target vessels in the IAT group. Upon discharge, 2/20 patients treated with PS and 7/20 patients treated with IAT had a NIHSS score of 0 to 1 or an improvement greater or equal to 10-point on the NIHSS scale. All cause mortality at 90 days was 3/20 patients treated with PS, and 2/20 patients treated with IAT. Three out of twenty patients treated with PS and 7/20 patients treated with IAT had a mRS of ≤ 2 at 90 days.
The Penumbra system is effective in re-opening occluded major arteries. Our data seems to indicate that not all patients benefit clinically from improved revascularization of occluded major arteries.
本研究旨在评估采用 Penumbra 系统（PS）治疗急性缺血性脑卒中患者的临床结果。为此，设计了一项回顾性、单中心配对分析，与采用阿替普酶治疗的动脉内溶栓（IAT）患者进行比较。
22 例连续急性缺血性脑卒中患者（平均年龄 62 岁），NIHSS 评分≥7 分，采用 PS 治疗。20 例相应患者可采用 IAT 治疗。针对初始 NIHSS 评分和靶血管，寻找匹配。比较溶栓治疗脑梗死（TIMI）分级、死亡率、出院时 NIHSS 评分和 90 天时改良 Rankin 评分（mRs）。
在研究的两支治疗组中，共有 32 条血管接受治疗。PS 组有 25/32（78%）的靶血管达到 TIMI 2/3 级再通，IAT 组有 17/32（53%）的靶血管达到 TIMI 2/3 级再通。出院时，PS 组 2/20 例患者和 IAT 组 7/20 例患者 NIHSS 评分降至 0-1 分或 NIHSS 评分提高≥10 分。PS 组和 IAT 组的全因死亡率分别为 3/20 例和 2/20 例。PS 组和 IAT 组分别有 3/20 例和 7/20 例患者 90 天时 mRs≤2。
Penumbra 系统在再通闭塞的主要动脉方面是有效的。我们的数据似乎表明，并非所有患者都能从闭塞的主要动脉再通中获得临床获益。
