Departments of Radiology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.
AJNR Am J Neuroradiol. 2011 Jun-Jul;32(6):1078-81. doi: 10.3174/ajnr.A2447. Epub 2011 Apr 14.
Patients with stroke unsuitable for IV thrombolysis may be considered for endovascular revascularization, particularly when baseline imaging suggests proximal cerebral vessel occlusion associated with minimal established infarction. This retrospective review describes the use of a self-expanding retrievable intracranial stent (Solitaire AB) for thrombectomy in acute ischemic stroke.
Twenty-six consecutive patients with stroke treated endovascularly by using the Solitaire stent were identified, followed by detailed review of data extracted from their imaging and clinical records.
Recanalization (TIMI grade ≥2) was achieved with Solitaire thrombectomy as the single treatment technique in 16 patients and in combination with urokinase or the Penumbra device in 9 of the remaining 10 patients. Two patients had symptomatic intracranial hemorrhage. A favorable clinical outcome (mRS score of ≤2) was seen in 3 of 5 patients with MCA occlusion, 6 of 11 (55%) patients with ICA occlusion, and 2 of 10 patients with BA occlusion.
Mechanical thrombectomy by using the Solitaire stent appears to be safe and is capable of achieving a high rate of recanalization and favorable clinical outcomes in patients presenting with proximal cerebral vessel occlusion.
不适合静脉溶栓的卒中患者可考虑血管内再通治疗,尤其是基线影像学提示存在近端脑动脉闭塞且已形成的梗死灶较小的患者。本回顾性研究描述了使用可回收颅内自膨支架(Solitaire AB)进行急性缺血性卒中取栓治疗。
共纳入 26 例行血管内治疗的卒中患者,对其影像学和临床资料进行详细评估。
16 例患者单纯使用 Solitaire 支架取栓达到再通(TIMI 分级≥2),9 例患者在剩余的 10 例患者中联合使用尿激酶或 Penumbra 装置。2 例患者发生症状性颅内出血。5 例 MCA 闭塞患者中有 3 例获得良好临床结局(mRS 评分≤2),11 例 ICA 闭塞患者中有 6 例(55%),10 例基底动脉闭塞患者中有 2 例。
使用 Solitaire 支架机械取栓治疗近端脑动脉闭塞患者安全有效,能获得较高的再通率和良好的临床结局。