Natarajan Sabareesh K, Sonig Ashish, Mocco J, Dumont Travis M, Thind Harjot, Hartney Mary L, Snyder Kenneth V, Hopkins L Nelson, Siddiqui Adnan H, Levy Elad I
Department of Neurosurgery, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, NY, USA ; Department of Neurosurgery, Gates Vascular Institute/Kaleida Health, Buffalo, NY, USA.
Departments of Neurological Surgery and Radiology and Radiological Sciences, Mount Sinai Health System, New York City, NY, USA.
J Vasc Interv Neurol. 2015 Jul;8(3):62-7.
The preliminary results of a prospective consecutive series of 20 patients who underwent Enterprise-assisted recanalization for acute ischemic stroke were recently reported. Recanalization to thrombolysis in myocardial infarction (TIMI) grade 2 (n = 6) or 3 (n = 12) flow was achieved in 18 patients (90% revascularization rate). Good outcome (modified Rankin Scale [mRS] score of ≤2) was obtained in 10 patients (50%) at 30 days. Here, we report the 2-year clinical follow-up data for patients enrolled in that prospective study.
Study patients were scheduled for examinations 2 years postprocedure at which time mRS and Barthel indices were obtained.
Among 12 survivors at 2 years, 11 of the 20 (55%) study patients improved to mRS score ≤2 and 1 (5%) patient was disabled with an mRS 4. Of the 11 patients with mRS 0-2 scores, 10 patients had a Barthel index of 100, and the 11th had a Barthel index of 95. One patient improved from mRS 3 to 2 during the interval between the 6- and 12-month postintervention evaluations after intervention. Eight of 13 (62%) survivors underwent follow-up imaging at 6 months without evidence of instent stenosis or thrombosis.
At 2 years of follow-up, improvement in quality of life after acute stroke intervention was sustained; and 11 of 12 (92%) survivors had an excellent functional outcome. Improvement in functional status can occur even up to 1 year after stroke intervention. These results 2 years after acute stroke intervention demonstrate sustained benefit from acute intervention.
AISacute ischemic strokeCTcomputed tomographicFDAFood and Drug AdministrationIVintravenousMCAmiddle cerebral arterymRSmodified Rankin ScaleNIHSSNational Institutes of Health Stroke Scale ScoreSWIFTSolitaire FR With the Intention For Thrombectomy (SWIFT)TIMIthrombolysis in myocardial infarctiontPAtissue plasminogen activatorTREVOThrombectomy REvascularization of large Vessel Occlusions.
最近报道了对20例接受Enterprise辅助再通治疗急性缺血性卒中的患者进行前瞻性连续系列研究的初步结果。18例患者（血管再通率为90%）实现了心肌梗死溶栓（TIMI）2级（n = 6）或3级（n = 12）血流再通。30天时，10例患者（50%）获得了良好预后（改良Rankin量表[mRS]评分≤2）。在此，我们报告该前瞻性研究中患者的2年临床随访数据。
研究患者在术后2年安排进行检查，此时获取mRS和Barthel指数。
在2年时的12名幸存者中，20名研究患者中有11名（55%）mRS评分改善至≤2，1名（5%）患者mRS评分为4级，存在残疾。在11名mRS评分为0 - 2的患者中，10名患者的Barthel指数为100，第11名患者的Barthel指数为95。1例患者在干预后6个月至12个月的间隔期内从mRS 3级改善至2级。13名幸存者中的8名（62%）在6个月时接受了随访影像学检查，未发现支架内狭窄或血栓形成的证据。
在2年的随访中，急性卒中干预后生活质量的改善得以持续；12名幸存者中有11名（92%）功能预后良好。即使在卒中干预后长达1年，功能状态仍可改善。急性卒中干预2年后的这些结果表明急性干预具有持续益处。
AIS急性缺血性卒中；CT计算机断层扫描；FDA食品药品监督管理局；IV静脉内；MCA大脑中动脉；mRS改良Rankin量表；NIHSS美国国立卫生研究院卒中量表评分；SWIFT Solitaire FR血栓切除术（SWIFT）；TIMI心肌梗死溶栓；tPA组织型纤溶酶原激活剂；TREVO大血管闭塞性血栓切除术血管再通术
