Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan; Department of Neurology, En Chu Kong Hospital, Taipei, Taiwan.
Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2018 Sep;117(9):806-813. doi: 10.1016/j.jfma.2017.09.016. Epub 2017 Oct 31.
BACKGROUND/PURPOSE: Endovascular thrombectomy has been strongly recommended for treatment of acute ischemic stroke (AIS) with large vessel occlusion. This study aimed to evaluate its efficacy and safety in an Asian population from a single center in Taiwan.
Patients who experienced AIS and received endovascular thrombectomy during the period of September 2014 to September 2016 at National Taiwan University Hospital were included. Factors related to favorable outcome, defined as modified Rankin scale 0-2 at 90 days after stroke, were analyzed.
During the study period, 65 patients (mean age, 71.9 ± 12.4 years; 44.6% females) received endovascular thrombectomy, including 33 who received intravenous thrombolysis before the endovascular treatment. A significant trend of increasing thrombectomy therapy was observed. The median National Institutes of Health Stroke Scale (NIHSS) score on admission was 19 (interquartile range, 15-26). The sites of vessel occlusion were middle cerebral artery in 47 (72.3%) patients, intracranial internal carotid artery in 8 (12.4%), anterior cerebral artery in 1 (1.5%), and basilar artery in 9 (13.8%). The median times from stroke onset to groin puncture and from groin puncture to recanalization time were 200 and 29.5 min, respectively. Successful revascularization was achieved in 41 (63.1%) patients. Two (3.1%) patients had symptomatic hemorrhagic transformation. At 90 days, 25 (38.5%) patients achieved favorable outcome. A shorter time from onset to puncture, and successful recanalization were independent predictors of favorable outcome.
This study demonstrated the therapeutic promise of endovascular thrombectomy for treatment of AIS with large vessel occlusion in a clinical setting.
背景/目的：血管内血栓切除术已被强烈推荐用于治疗伴有大血管闭塞的急性缺血性脑卒中（AIS）。本研究旨在评估来自中国台湾地区单中心的亚洲人群中该方法的疗效和安全性。
纳入 2014 年 9 月至 2016 年 9 月期间在国立台湾大学医院接受血管内血栓切除术治疗的 AIS 患者。分析与 90 天后改良 Rankin 量表评分 0-2 相关的预后因素。
研究期间，共有 65 例患者（平均年龄 71.9±12.4 岁，44.6%为女性）接受了血管内血栓切除术，其中 33 例在血管内治疗前接受了静脉溶栓治疗。血管内血栓切除术的治疗趋势呈显著增加趋势。入院时的美国国立卫生研究院卒中量表（NIHSS）评分中位数为 19（四分位距，15-26）。血管闭塞部位：大脑中动脉 47 例（72.3%），颅内颈内动脉 8 例（12.4%），大脑前动脉 1 例（1.5%），基底动脉 9 例（13.8%）。从发病到股动脉穿刺及从股动脉穿刺到再通的中位时间分别为 200 和 29.5min。41 例（63.1%）患者实现了再通。2 例（3.1%）患者发生症状性出血性转化。90 天时，25 例（38.5%）患者预后良好。发病至穿刺时间较短和再通成功是预后良好的独立预测因素。
本研究表明血管内血栓切除术在伴有大血管闭塞的 AIS 患者的临床治疗中具有良好的治疗前景。
