Sila Dalibor, Lenski Markus, Vojtková Maria, Elgharbawy Mustafa, Charvát František, Rath Stefan
Department of Neurosurgery and Interventional Neuroradiology, Donau-Isar Klinikum, Perlasberger Str. 41, 94469 Deggendorf, Germany.
Neurosurgical Clinic, Campus Grosshadern, Clinic of the University of Munich (LMU), Marchioninistrasse 15, 81377 Munich, Germany.
Brain Sci. 2021 Apr 16;11(4):504. doi: 10.3390/brainsci11040504.
Mechanical thrombectomy is the standard therapy in patients with acute ischemic stroke (AIS). The primary aim of our study was to compare the procedural efficacy of the direct aspiration technique, using Penumbra ACE aspiration catheter, and the stent retriever technique, with a Solitaire FR stent. Secondarily, we investigated treatment-dependent and treatment-independent factors that predict a good clinical outcome.
We analyzed our series of mechanical thrombectomies using a Solitaire FR stent and a Penumbra ACE catheter. The clinical and radiographic data of 76 patients were retrospectively reviewed. Using binary logistic regression, we looked for the predictors of a good clinical outcome.
In the Penumbra ACE group we achieved significantly higher rates of complete vessel recanalization with lower device passage counts, shorter recanalization times, shorter procedure times and shorter fluoroscopy times ( < 0.001) compared to the Solitaire FR group. We observed no significant difference in good clinical outcomes (52.4% vs. 56.4%, = 0.756). Predictors of a good clinical outcome were lower initial NIHSS scores, pial arterial collateralization on admission head CT angiography scan, shorter recanalization times and device passage counts.
The aspiration technique using Penumbra ACE catheter is comparable to the stent retriever technique with Solitaire FR regarding clinical outcomes.
机械取栓术是急性缺血性卒中（AIS）患者的标准治疗方法。我们研究的主要目的是比较使用Penumbra ACE抽吸导管的直接抽吸技术与使用Solitaire FR支架的支架取栓技术的手术疗效。其次，我们研究了预测良好临床结局的治疗相关和非治疗相关因素。
我们分析了使用Solitaire FR支架和Penumbra ACE导管进行的一系列机械取栓术。回顾性分析了76例患者的临床和影像学数据。使用二元逻辑回归，我们寻找良好临床结局的预测因素。
与Solitaire FR组相比，Penumbra ACE组实现了显著更高的完全血管再通率，器械通过次数更少，再通时间更短，手术时间更短，透视时间更短（P<0.001）。我们观察到良好临床结局方面无显著差异（52.4%对56.4%，P=0.756）。良好临床结局的预测因素是初始美国国立卫生研究院卒中量表（NIHSS）评分较低、入院时头部CT血管造影扫描显示软脑膜动脉侧支循环、再通时间和器械通过次数较短。
就临床结局而言，使用Penumbra ACE导管的抽吸技术与使用Solitaire FR的支架取栓技术相当。
