Department of Radiology, Faculty Hospital Trnava, Trnava, Slovakia.
Department of Neurology, Faculty Hospital Trnava, Trnava, Slovakia.
Interv Neuroradiol. 2020 Aug;26(4):376-382. doi: 10.1177/1591019920911532. Epub 2020 Mar 17.
Data on the treatment with recurrent mechanical thrombectomy of patients with acute ischemic stroke with recurrent large vessel occlusion are limited. We report our experience with recurrent mechanical thrombectomy for recurrent large vessel occlusion.
During the period between May 2013 and August 2018, data on patients with recurrent large vessel occlusion were collected. Baseline clinical characteristics, recanalization technique, recanalization rates and clinical outcomes of patients with recurrent large vessel occlusion treated with mechanical thrombectomy were analyzed. Patients with recurrent large vessel occlusion treated with mechanical thrombectomy were compared with patients who underwent single mechanical thrombectomy.
During the study period, 7 of 474 patients (1.5%) were treated with mechanical thrombectomy for recurrent large vessel occlusion. The mean age of these patients was 64.4 (±7.9) years, and the mean time interval between thrombectomies was 47 (±48) h. The median baseline National Institutes of Health Stroke Scale (NIHSS) was 12 (range 5-24) before the first and 20 (range 3-34) before the second procedure; the mean NIHSS at discharge was 5 (range 2-25). Good clinical outcome after repeated mechanical thrombectomy defined as modified Rankin scale of 0-2 was achieved in 29% of patients at three months of follow-up.
Repeat mechanical thrombectomy is a rare procedure, but appears to be a feasible, safe and effective treatment option in patients with acute ischemic stroke and early recurrent large vessel occlusion.
关于急性缺血性脑卒中伴复发性大血管闭塞患者接受反复机械取栓治疗的数据有限。我们报告了我们在复发性大血管闭塞患者中反复进行机械取栓的经验。
在 2013 年 5 月至 2018 年 8 月期间，收集了复发性大血管闭塞患者的数据。分析了接受机械取栓治疗的复发性大血管闭塞患者的基线临床特征、再通技术、再通率和临床结局。将接受机械取栓治疗的复发性大血管闭塞患者与接受单次机械取栓治疗的患者进行比较。
在研究期间，474 例患者中有 7 例（1.5%）接受机械取栓治疗复发性大血管闭塞。这些患者的平均年龄为 64.4（±7.9）岁，两次取栓之间的平均时间间隔为 47（±48）小时。首次取栓前的中位 NIHSS 为 12（范围 5-24），第二次取栓前为 20（范围 3-34）；出院时 NIHSS 的平均值为 5（范围 2-25）。在 3 个月的随访中，29%的患者重复机械取栓后达到改良 Rankin 量表评分为 0-2 的良好临床转归。
重复机械取栓是一种罕见的操作，但对于急性缺血性脑卒中伴早期复发性大血管闭塞的患者来说，似乎是一种可行、安全和有效的治疗选择。
