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急性缺血性脑卒中机械取栓中 Sofia Plus 与支架取栓的临床疗效对比

Clinical Result of Mechanical Thrombectomy Using Sofia Plus with Acute Ischemic Stroke Compared with the Stent Retriever.

机构信息

Department of Neurosurgery, Osaka Medical College, Takatsuki, Osaka, Japan.

Department of Neurosurgery, Shimizu Hospital, Kyoto, Japan.

出版信息

World Neurosurg. 2021 May;149:e11-e15. doi: 10.1016/j.wneu.2021.02.106. Epub 2021 Feb 27.

Abstract

OBJECTIVE

The Sofia catheter is a new large-bore aspiration catheter that allows easy access and good reperfusion. In this study, we analyzed the efficacy and safety of the Sofia catheter in comparison with stent retrievers as a contact aspiration thrombectomy (CAT) tool for large vessel occlusion.

METHODS

We enrolled patients with acute ischemic stroke who underwent endovascular thrombectomy from April 2017 and April 2020 in our hospital. Patients were retrospectively reviewed and divided into the stent retriever group (SR), the Sofia group, and all cases group.

RESULTS

A total of 114 patients were treated during the study period, including 27 in the stent retriever group and 15 in the Sofia group. Higher rates of the first-pass effect (FPE) (37% vs. 47%, P = 0.12) and significantly higher modified FPE (44% vs. 67%, P = 0.001) were observed in patients with SR and Sofia, respectively. Functional independence (modified Rankin Scale ≤2) at 30 days after onset was observed in 30% versus 47% (P = 0.47) of SR and Sofia, respectively.

CONCLUSIONS

The Sofia Plus is a large-bore aspiration catheter with high FPE and good accessibility. Use of this catheter resulted better angiographic outcome compared with the stent retriever, but there was no difference in clinical outcomes in this study. Further studies are needed to compare in new generation aspiration catheters.

摘要

目的

Sofia 导管是一种新型的大口径抽吸导管,可实现便捷的进入和良好的再灌注。本研究旨在分析 Sofia 导管与支架取栓器作为接触抽吸血栓切除术(CAT)工具治疗大血管闭塞的疗效和安全性。

方法

回顾性分析 2017 年 4 月至 2020 年 4 月在我院接受血管内血栓切除术的急性缺血性脑卒中患者。将患者分为支架取栓器组(SR)、Sofia 组和全部病例组。

结果

研究期间共治疗 114 例患者,其中支架取栓器组 27 例,Sofia 组 15 例。SR 和 Sofia 组的首次通过效应(FPE)(37% vs. 47%,P=0.12)和改良 FPE(44% vs. 67%,P=0.001)的比例更高。发病后 30 天的功能性独立(改良 Rankin 量表≤2)在 SR 组和 Sofia 组中分别为 30%和 47%(P=0.47)。

结论

Sofia Plus 是一种大口径抽吸导管,具有较高的 FPE 和良好的可及性。与支架取栓器相比,该导管的血管造影结果更好,但本研究中临床结局无差异。需要进一步研究比较新一代抽吸导管。

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