Department of Interventional Neuroradiology, People's Hospital of Rizhao, Rizhao, Shandong Province, China.
Eur Rev Med Pharmacol Sci. 2017 Oct;21(19):4340-4345.
Acute ischemic stroke (AIS) is an important global health problem. Intravenous (IV) thrombolysis with recombinant tissue plasminogen activator (rt-PA) is the standard treatment. However, only a small number of patients benefit from it because of strict application restrictions. Increasing evidence has demonstrated that mechanical thrombectomy is an effective and safe therapy for AIS.
We present 14 cases of successful recanalization with Solitaire devices for AIS patients after stroke onset. During stent retrieval, continuous manual aspiration was applied through the guiding catheter, and several large pieces of thrombus were aspirated into the catheter along with the clot, which was adhered to the stent. Clinical outcomes were assessed by the NIHSS at discharge and the mRS on follow-up at 90 days.
All 14 patients with AIS occlusions were treated with Solitaire stents during the study period. The successful recanalization rate was 100%. On discharge, all patients (100%) had improved (NIHSS of ≥ 10 points). At 90 days, 12 patients (86%) had a good functional outcome with mRS of ≤ 2.
We recommend the use of manual aspiration through a guiding catheter as an alternative technique when a specialized aspiration device is not available, to facilitate a fast, complete, and safe thrombus retrieval by the Solitaire system.
急性缺血性脑卒中（AIS）是一个重要的全球健康问题。静脉（IV）溶栓治疗采用重组组织型纤溶酶原激活剂（rt-PA）是标准治疗方法。然而，由于严格的应用限制，只有少数患者从中受益。越来越多的证据表明，机械取栓治疗 AIS 是一种有效且安全的治疗方法。
我们报告了 14 例 AIS 患者发病后使用 Solitaire 装置成功再通的病例。在支架取栓过程中，通过引导导管持续进行手动抽吸，将数大块血栓与支架一起抽吸到导管中。通过 NIHSS 在出院时和 90 天随访时的 mRS 评估临床结局。
在研究期间，所有 14 例 AIS 闭塞患者均使用 Solitaire 支架进行治疗。再通成功率为 100%。出院时，所有患者（100%）均有改善（NIHSS≥10 分）。90 天时，12 例患者（86%）具有良好的功能结局，mRS≤2。
当没有专用抽吸装置时，我们建议使用引导导管进行手动抽吸作为替代技术，以促进 Solitaire 系统快速、完全和安全地取栓。
