Department of Neuroradiology, Heidelberg University Hospital, Germany.
Department of Neurology, Heidelberg University Hospital, Germany.
Neuroradiol J. 2020 Aug;33(4):286-291. doi: 10.1177/1971400920925433. Epub 2020 May 18.
This study aimed to compare radiation exposure (RE) in patients receiving mechanical thrombectomy (MT) for large-vessel occlusions in the anterior circulation using direct thrombo-aspiration (DT) versus stent-retriever thrombectomy under continuous distal aspiration (STA).
This was a retrospective single-centre analysis of an Institutional Review Board-approved stroke database of a comprehensive stroke centre focusing on RE per dose area product, procedure time (PT) and fluoroscopy time (FT) in patients receiving MT. Patients who received MT with DT were matched with patients treated using STA according to occlusion location, mode of anaesthesia, manoeuvre count and sex.
Apart from patient age (DT: = 74 years (standard deviation ()=13 years); STA: = 79 years ( = 11 years); = 0.023), there was no difference in baseline patient characteristics ( = 68 per group). PT (DT: median = 26 minutes (interquartile range (IQR) = 21-38 minutes); STA: median = 49 minutes (IQR 37-77 minutes); < 0.0001) and FT (DT: median = 12 minutes (IQR 7-18 minutes); STA: median = 26 minutes (IQR 14-43 minutes); < 0.0001) were shorter in patients who received MT using DT. RE (DT: median = 62.6 Gy·cm (IQR 41.7-89.4 Gy·cm); STA: median = 89.8 Gy·cm (IQR 53.7-131.7 Gy·cm); = 0.034) was significantly lower in patients who received MT using DT. This represents a relative increase of RE, FT and PT by 43.6%, 116.6% and 88.5%, respectively, in patients who received MT using STA.
MT using DT is associated with shorter FT and PT and lower RE compared to matched patients treated with STA.
本研究旨在比较直接血栓抽吸（DT）与支架取栓联合持续远端抽吸（STA）治疗前循环大血管闭塞患者机械取栓术（MT）的辐射暴露（RE）。
这是一项回顾性单中心分析，对一家专注于剂量面积产品、手术时间（PT）和透视时间（FT）的机构审查委员会批准的中风数据库进行分析，纳入接受 MT 的患者。根据闭塞部位、麻醉方式、操作次数和性别，将接受 DT 治疗的 MT 患者与接受 STA 治疗的患者进行匹配。
除了患者年龄（DT：=74 岁（标准差（）=13 岁）；STA：=79 岁（=11 岁）；=0.023）外，两组患者的基线特征无差异（每组=68 例）。PT（DT：中位数=26 分钟（四分位距（IQR）=21-38 分钟）；STA：中位数=49 分钟（IQR 37-77 分钟）；<0.0001）和 FT（DT：中位数=12 分钟（IQR 7-18 分钟）；STA：中位数=26 分钟（IQR 14-43 分钟）；<0.0001）在接受 DT 治疗的 MT 患者中更短。接受 DT 治疗的 MT 患者的 RE（DT：中位数=62.6 Gy·cm（IQR 41.7-89.4 Gy·cm）；STA：中位数=89.8 Gy·cm（IQR 53.7-131.7 Gy·cm）；=0.034）显著低于接受 STA 治疗的患者。这代表接受 STA 治疗的患者的 RE、FT 和 PT 分别增加了 43.6%、116.6%和 88.5%。
与匹配的接受 STA 治疗的患者相比，DT 治疗 MT 与较短的 FT 和 PT 以及较低的 RE 相关。
