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经桡动脉入路行后循环卒中介入治疗;血栓切除术治疗量较高中心的最初 12 个月经验。

First line transradial access for posterior circulation stroke intervention; initial 12-month experience at a high volume thrombectomy center.

机构信息

Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia.

Neurological Intervention and Imaging Service of Western Australia, Sir Charles Gairdner Hospital, Perth, Western Australia.

出版信息

J Clin Neurosci. 2020 Aug;78:194-197. doi: 10.1016/j.jocn.2020.04.069. Epub 2020 Apr 23.

Abstract

BACKGROUND

The Neurointerventional Surgery Standards and Guidelines Committee has advocated the use of transradial access in the setting of posterior circulation stroke intervention, however there is a paucity of published data on this approach. The purpose of this study is to present 12-months of prospectively collected data from a high volume thrombectomy center following the adoption of a first line transradial approach for posterior circulation stroke intervention.

METHODS

A range of data on patient characteristics, procedural metrics, complications and outcomes was prospectively collected between August 2018 - August 2019 following the adoption of first line transradial access for posterior circulation stroke intervention at a high volume thrombectomy center.

RESULTS

Transradial access was successful in 22/23 cases (96%), median arteriotomy to reperfusion time was 24 min (IQR 18-40), good angiographic outcome (mTICI 2b-3) was achieved in all cases and good clinical outcome (mRs 0-2) was achieved in 61% of cases. No intracranial or radial artery access site complications occurred.

CONCLUSION

The fast procedure times, excellent outcomes and low complication rates achieved in this prospective 12-month study indicate that transradial access is a viable first line strategy in posterior circulation stroke intervention.

摘要

背景

神经介入手术标准和指南委员会提倡在后循环卒中介入治疗中使用经桡动脉入路,但关于这种方法的发表数据很少。本研究的目的是报告一家高容量取栓中心在采用经桡动脉入路作为后循环卒中介入治疗的一线方法后,前瞻性收集的 12 个月数据。

方法

在一家高容量取栓中心采用经桡动脉入路作为后循环卒中介入治疗的一线方法后,于 2018 年 8 月至 2019 年 8 月期间前瞻性收集了一系列关于患者特征、手术指标、并发症和结局的数据。

结果

23 例中有 22 例(96%)桡动脉入路成功,中位动脉切开至再灌注时间为 24 分钟(IQR 18-40),所有病例均获得良好的血管造影结果(mTICI 2b-3),61%的病例获得良好的临床结局(mRs 0-2)。无颅内或桡动脉入路部位并发症发生。

结论

这项前瞻性 12 个月研究中取得的快速手术时间、优异的结局和低并发症发生率表明,经桡动脉入路在后循环卒中介入治疗中是一种可行的一线策略。

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