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Trevo 系统:新型机械取栓装置的单中心经验。

Trevo System: single-center experience with a novel mechanical thrombectomy device.

机构信息

Department of Neurology, University Hospital of Coimbra, Coimbra, Portugal.

出版信息

J Neuroimaging. 2013 Jan;23(1):7-11. doi: 10.1111/j.1552-6569.2011.00666.x. Epub 2011 Dec 30.

Abstract

BACKGROUND AND PURPOSE

Recent reports have indicated that mechanical thrombectomy may have the potential to treat acute ischemic stroke. This study aims to describe the safety and effectiveness of Trevo Retriever, using Stentriever technology, in revascularization of patients with acute ischemic stroke.

METHODS

Prospective study evaluating the clinical, radiological, and functional outcome of 13 patients with an angiographically verified occlusion of the anterior cerebral circulation. All patients underwent thrombectomy with TR as monotherapy or in combination with intra-arterial thrombolysis, within the first 8 hours from the onset of symptoms. Successful revascularization was defined as thrombolysis in cerebral ischemia grade 2a to 3. Good outcome was defined as modified Rankin Scale score ≤ 2.

RESULTS

Median baseline National Institutes of Health Stroke Scale score was 19(16-22). The occlusion site was middle cerebral artery in 8 patients and internal carotid artery in 5 patients. Revascularization was achieved in 10 of 13 patients (77%). The mean time from groin puncture to recanalization was 95 ± 31 minutes. No significant intra-procedural complications occurred. Four patients (30%) died during the 90-day follow-up period and 4 patients (30%) achieved functional independence.

CONCLUSION

Early clinical experience suggests that the TR can allow safe and effective revascularization in certain subjects with acute ischemic stroke.

摘要

背景与目的

最近的报告表明,机械取栓术可能有潜力治疗急性缺血性脑卒中。本研究旨在描述 Trevo Retriever(使用支架取栓技术)在急性缺血性脑卒中患者血管再通中的安全性和有效性。

方法

前瞻性研究评估了 13 例经血管造影证实的前循环闭塞患者的临床、影像学和功能结局。所有患者均在症状发作后 8 小时内接受了单独使用 TR 或与动脉内溶栓联合的血栓切除术。成功的血管再通定义为血栓溶解程度为 2a 至 3 级。良好的结局定义为改良 Rankin 量表评分≤2。

结果

中位数基线国立卫生研究院卒中量表评分为 19(16-22)。闭塞部位为 8 例患者的大脑中动脉和 5 例患者的颈内动脉。13 例患者中有 10 例(77%)实现了血管再通。从腹股沟穿刺到再通的平均时间为 95±31 分钟。无明显术中并发症。4 例(30%)患者在 90 天随访期间死亡,4 例(30%)患者实现了功能独立性。

结论

早期临床经验表明,TR 可以在前循环急性缺血性脑卒中患者中安全有效地实现血管再通。

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