Jia Z C, Li X, Li X G, Zeng X Z, Luan J Y, Wang C M, Han J T
Department of Interventional Radiologyand Vascular Surgery, Peking University Third Hospital, Beijing 100191, China.
Department of Radiology, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2019 Apr 18;51(2):256-259. doi: 10.19723/j.issn.1671-167X.2019.02.010.
To evaluate the effectiveness and safety of mechanical thrombectomy treatment in patients with acute ischemic stroke (AIS),and to explore influential factors of the clinical prognosis preliminarily.
Clinical data of 26 patients with acute cerebral arterial occlusion treated with mechanical thrombectomy in Peking University Third Hospital from January 2014 to June 2017 were retrospectively collected. The immediate effects of the 26 patients in this group after mechanical thrombectomy treatment were analyzed,The national institutes of health stroke scale (NIHSS) scores between preoperative and at discharge of the 26 patients in this group were compared,and modified Rankin scale (mRS) scores of 90 days post operation were analyzed to assess the prognosis of the 26 patients in this group.
(1)In this group, 23 patients (88.5%) achieved vascular recanalization evaluated by thrombolysis in cerebral ischemia scale scores [thrombolysis in cerebral ischemia scale (TICI) scores, 3/2b grades were recognized as vascular recanalization], 19 patients of them reached TICI grade 3 and 4 atients reached TICI grade 2b. In this group 3 patients (11.5%) encountered symptomatic intracranial hemorrhage, 2 patients of them recovered after cerebral hemorrhage absorbed and 1 patient died of massive cerebral hemorrhage. In this group 4 patients (15.4%) died after mechanical thrombectomy treatment,2 patients died of hernia of the brain caused by severe cerebral edema, 1 patient died of symptomatic intracranial hemorrhage and 1 patient died of extensive subarachnoid hemorrhage. (2)The assessment of NIHSS scores at discharge(5.3±2.1)showed significantly lower than those preoperatively(12.6±4.2), P<0.01,and in this group 12 patients (46.2%) achieved favourable prognosis (defined as mRS scores 0-2), 6 patients of them reached mRS 0 score,4 patients reached mRS 1 score and 2 patients reached mRS 2 scores.
Mechanical thrombectomy with stent retriever contributed to a high rate of vascular recanalization and favourable prognosis,but some patients had poor prognosis, suggesting that we should screen the enrolled patients strictly.
评估机械取栓治疗急性缺血性卒中（AIS）患者的有效性和安全性，并初步探讨临床预后的影响因素。
回顾性收集2014年1月至2017年6月在北京大学第三医院接受机械取栓治疗的26例急性脑动脉闭塞患者的临床资料。分析该组26例患者机械取栓治疗后的即刻效果，比较该组26例患者术前和出院时的美国国立卫生研究院卒中量表（NIHSS）评分，并分析术后90天的改良Rankin量表（mRS）评分以评估该组26例患者的预后。
（1）该组中，23例患者（88.5%）经脑缺血溶栓量表评分评估实现血管再通[脑缺血溶栓量表（TICI）评分，3/2b级被视为血管再通]，其中19例患者达到TICI 3级，4例患者达到TICI 2b级。该组3例患者（11.5%）发生症状性颅内出血，其中2例患者在脑出血吸收后恢复，1例患者死于大量脑出血。该组4例患者（15.4%）在机械取栓治疗后死亡，2例患者死于严重脑水肿导致的脑疝，1例患者死于症状性颅内出血，1例患者死于广泛蛛网膜下腔出血。（2）出院时NIHSS评分评估结果（5.3±2.1）显著低于术前（12.6±4.2），P<0.01，该组12例患者（46.2%）获得良好预后（定义为mRS评分0 - 2），其中6例患者达到mRS 0分，4例患者达到mRS 1分，2例患者达到mRS 2分。
使用支架取栓器进行机械取栓有助于实现较高的血管再通率和良好预后，但部分患者预后较差，提示应严格筛选入选患者。
