Koh Jun Seok, Lee Sun Joo, Ryu Chang-Woo, Kim Ho Sung
Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Neurointervention. 2012 Feb;7(1):1-9. doi: 10.5469/neuroint.2012.7.1.1. Epub 2012 Feb 29.
In recent years, mechanical thrombectomy using Solitaire stent retrieval has been tried for treating acute ischemic stroke with a large artery occlusion. We systematically reviewed published articles to appraise the evidence that supports the safety and efficacy of the mechanical thrombectomy in acute strokes with Solitaire stent.
Systematic searches using Medline and Scopus were performed for studies evaluating mechanical thrombectomy using a Solitaire stent in acute ischemic stroke. Articles were included if they were published since 2008, contained at least 5 subjects, and provided clinical results.
Thirteen articles (262 cases) were included in this review. The mean time of the procedures ranged from 37 to 95.6 minutes in 10 studies. The success of recanalization was achieved in 89.7% and the recanalization rate varied from 66.7% to 100% in all 13 studies. The overall rates of the symptomatic hemorrhagic complications and mortality were 6.8% and 11.1%, respectively. A favorable outcome of mRS 2 or under was 47.3%. Procedure-induced complications developed in 3.4%.
The present review suggested that mechanical thrombectomy using a Solitaire stent in acute ischemic stroke was effective in recanalizing the occluded artery. The rate of procedural complications was small.
近年来，已尝试使用Solitaire支架取栓术治疗伴有大动脉闭塞的急性缺血性卒中。我们系统回顾已发表的文章，以评估支持Solitaire支架用于急性卒中机械取栓术安全性和有效性的证据。
使用Medline和Scopus进行系统检索，以查找评估Solitaire支架用于急性缺血性卒中机械取栓术的研究。如果文章自2008年以来发表、包含至少5名受试者并提供临床结果，则纳入研究。
本综述纳入了13篇文章（262例）。10项研究中手术的平均时间为37至95.6分钟。在所有13项研究中，再通成功率为89.7%，再通率从66.7%到100%不等。有症状出血并发症和死亡率的总体发生率分别为6.8%和11.1%。改良Rankin量表（mRS）评分为2或更低的良好结局为47.3%。手术引起的并发症发生率为3.4%。
本综述表明，Solitaire支架用于急性缺血性卒中的机械取栓术在使闭塞动脉再通方面是有效的。手术并发症发生率较低。
