Akpinar Cetin Kursad, Gurkas Erdem, Aykac Ozlem, Inanc Yusuf, Giray Semih, Ozdemir Atilla Ozcan
Deparment of Neurology, Samsun Training and Research Hospital, Samsun, Turkey.
Department of neurology, Lütfi Kırdar Training and Research Hospital, İstanbul, Turkey.
Neurointervention. 2020 Jul;15(2):60-66. doi: 10.5469/neuroint.2020.00010. Epub 2020 May 26.
In a minority of cases, the transfemoral approach cannot be performed due to unfavorable anatomical barriers. In such cases, direct common carotid artery puncture (DCCAP) is an important alternative for rescue mechanical thrombectomy. The purpose of this study was to evaluate the efficacy and safety of DCCAP in patients with an unaccessible femoral route for mechanical thrombectomy.
This is a retrospective study using data in the Turkish Interventional Neurology Database recorded between January 2015 and April 2019. Twenty-five acute stroke patients treated with DCCAP were analyzed in this study. Among 25 cases with carotid puncture, 4 cases were excluded due to an aborted thrombectomy attempt resulting from unsuccessful sheath placement.
Patients had a mean age of 69±12 years. The average National Institutes of Health Stroke Scale score was 16±4. Successful revascularization (modified Thrombolysis In Cerebral Infarction 2b-3) rate was 86% (18/21), and 90-day good functional outcome rate (modified Rankin Scale 0-2) was 38% (8/21).
DCCAP is a rescue alternative for patients with unfavorable access via the transfemoral route. Timely switching to DCCAP is crucial in these cases.
在少数情况下，由于解剖结构不利，无法采用经股动脉途径。在此类情况下，直接颈总动脉穿刺（DCCAP）是挽救性机械取栓的重要替代方法。本研究的目的是评估DCCAP在机械取栓时无法通过股动脉途径到达的患者中的有效性和安全性。
这是一项回顾性研究，使用了2015年1月至2019年4月记录在土耳其介入神经病学数据库中的数据。本研究分析了25例接受DCCAP治疗的急性卒中患者。在25例颈动脉穿刺病例中，4例因鞘管置入不成功导致取栓尝试中止而被排除。
患者的平均年龄为69±12岁。美国国立卫生研究院卒中量表平均评分为16±4。成功再血管化（改良脑梗死溶栓2b-3级）率为86%（18/21），90天良好功能预后率（改良Rankin量表0-2级）为38%（8/21）。
DCCAP是经股动脉途径无法到达的患者的一种挽救性替代方法。在这些情况下，及时改用DCCAP至关重要。
