Department of Neurology, New York Medical College, Valhalla, New York, USA.
J Neurointerv Surg. 2013 Mar;5(2):135-8. doi: 10.1136/neurintsurg-2011-010216. Epub 2012 Feb 13.
The Penumbra system is effective for recanalization of the primary arterial occlusion (PAO) in acute stroke. However, clinical outcomes are not as promising. The authors hypothesized that the formation of procedural distal emboli (PDE) during mechanical thrombectomy may lead to poorer patient outcomes.
DESIGN/METHODS: A retrospective review of patients with acute ischemic stroke treated with the Penumbra system was undertaken. Patients' outcome was evaluated by comparing discharge National Institute of Health stroke scale and modified Rankin score (mRS) of patients with and without PDE.
Out of 20 patients reviewed, recanalization of PAO was 100%. Six patients (30%) were confirmed to have PDE, of which two died (33.3%) and one (16.7%) had mRS of 2 or less. Of the 14 patients without PDE, three died (21.4%) and six (42.9%) had mRS of 2 or less. In the patient group who survived, mean National Institute of Health stroke scale decrease was only 2.3 in patients with PDE versus a decrease of 10.6 in patients without PDE.
In spite of PAO recanalization, distal emboli formed subsequent to Penumbra thrombectomy may contribute to poorer clinical outcome in acute stroke patients.
Penumbra 系统对于急性中风患者的原发性动脉闭塞（PAO）再通是有效的。然而，临床结果并不那么乐观。作者假设在机械血栓切除术中形成的程序性远端栓塞（PDE）可能导致患者预后较差。
方法/设计：对接受 Penumbra 系统治疗的急性缺血性中风患者进行了回顾性研究。通过比较有和无 PDE 患者的出院时国立卫生研究院中风量表（NIHSS）和改良 Rankin 量表（mRS）来评估患者的预后。
在 20 名接受治疗的患者中，PAO 的再通率为 100%。有 6 名（30%）患者被证实有 PDE，其中 2 人死亡（33.3%），1 人（16.7%）mRS 为 2 或更低。在没有 PDE 的 14 名患者中，3 人死亡（21.4%），6 人（42.9%）mRS 为 2 或更低。在存活的患者组中，有 PDE 的患者 NIHSS 评分平均下降 2.3，而无 PDE 的患者下降 10.6。
尽管 PAO 再通，但随后在 Penumbra 血栓切除术中形成的远端栓塞可能导致急性中风患者的临床预后较差。
