Department of Neurosurgery, Saga-Ken Medical Centre Koseikan, Saga, Japan.
Department of Cerebrovascular Medicine, Saga-Ken Medical Centre Koseikan, Saga, Japan.
J Stroke Cerebrovasc Dis. 2019 Oct;28(10):104301. doi: 10.1016/j.jstrokecerebrovasdis.2019.07.017. Epub 2019 Jul 31.
The important factor for successful first-pass complete reperfusion (FPR) after combined techniques for mechanical thrombectomy (MT) is unclear. We consider that for successful FPR, the aspiration catheter (AC) should reach to and hold the thrombus before the device is pulled out. Therefore, we defined an ART (AC reached thrombus) sign characterized by the cessation of reverse blood flow in aspiration pump and deformation of stent retriever (SR) at the tip of AC. The purpose of this study was to identify the impact of the ART sign on the outcomes of the combined techniques.
A retrospective analysis was conducted between January 2015 and September 2018 on the data of consecutive patients who underwent MT for anterior circulation stroke using both SR and AC at the first-pass procedure. We divided the patients into 2 groups based on whether the first-pass procedure achieved the ART sign (ARTs group) or not (Non-ARTs group). The primary endpoint was FPR defined as modified thrombolysis in cerebral infarction (mTICI) score of 3.
Sixty-six patients were included in our study (n = 38, ARTs group; n = 28, Non-ARTs group). There were no differences at mTICI 2b/3 (97.3% versus 89.2%, P = .30), but the FPR and mTICI3 were more common in the ARTs group (81.5% versus 14.2%, P < .001; and 89.4% versus 32.1%, P < .001, respectively).
ART sign in combined technique was found to be an important factor for successful FPR.
联合机械血栓切除术（MT）后首次通过完全再通（FPR）成功的重要因素尚不清楚。我们认为，要实现成功的 FPR，抽吸导管（AC）应在器械拔出前到达并抓住血栓。因此，我们定义了一个抽吸导管到达血栓（ART）征，其特征为抽吸泵中的逆行血流停止和抽吸导管尖端的支架回收器（SR）变形。本研究的目的是确定 ART 征对联合技术结果的影响。
回顾性分析了 2015 年 1 月至 2018 年 9 月期间接受首次使用 SR 和 AC 进行 MT 的前循环卒中患者的数据。我们根据首次通过程序是否实现 ART 征（ARTS 组）将患者分为 2 组。主要终点是定义为改良脑梗死溶栓（mTICI）评分 3 的 FPR。
本研究共纳入 66 例患者（n=38，ARTS 组；n=28，Non-ARTs 组）。mTICI 2b/3 无差异（97.3%与 89.2%，P=.30），但 ARTS 组的 FPR 和 mTICI3 更常见（81.5%与 14.2%，P<0.001；89.4%与 32.1%，P<0.001）。
联合技术中的 ART 征是 FPR 成功的重要因素。
