Tsuji Yuichiro, Miki Takanori, Kakita Hiroto, Sato Kimitoshi, Yoshida Takashi, Shimizu Fuminori
Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan.
Department of Neurosurgery, Shimizu Hospital, Kyoto, Kyoto, Japan.
Neurointervention. 2020 Jun;15(2):89-95. doi: 10.5469/neuroint.2020.00136. Epub 2020 Jun 17.
Mechanical thrombectomy has become a standard treatment for acute ischemic stroke with large vessel occlusion. In aged patients, it is difficult to guide the catheter via the transfemoral approach due to vessel tortuosity and aortic elongation. We report our preliminary clinical experience using the transbrachial approach. Among the 119 patients who underwent thrombectomy from April 2018 to December 2019, a total of 5 patients were treated via the transbrachial approach. Clinical outcomes were retrospectively analyzed. Successful reperfusion was achieved in 4 out of 5 cases. There was 1 death due to symptomatic intracranial hemorrhage. One patient had a good outcome at discharge. There were no access-site complications associated with any of these cases. Transbrachial access for mechanical thrombectomy is feasible and can provide an alternative to the transfemoral approach.
机械取栓术已成为治疗急性大血管闭塞性缺血性卒中的标准方法。在老年患者中，由于血管迂曲和主动脉延长，经股动脉途径引导导管较为困难。我们报告了使用经肱动脉途径的初步临床经验。在2018年4月至2019年12月接受取栓术的119例患者中，共有5例通过经肱动脉途径进行治疗。对临床结果进行了回顾性分析。5例中有4例实现了成功再灌注。有1例因症状性颅内出血死亡。1例患者出院时预后良好。这些病例均未出现与穿刺部位相关的并发症。经肱动脉途径进行机械取栓是可行的，可为经股动脉途径提供一种替代方法。
