Department of Neurology, Haian People's Hospital, Haian, Jiangsu, China.
Department of Neurology, Haian People's Hospital, Haian, Jiangsu, China.
Clinics (Sao Paulo). 2023 Aug 24;78:100262. doi: 10.1016/j.clinsp.2023.100262. eCollection 2023.
Second-generation catheters used in mechanical thrombectomy have different advantages and disadvantages. The objective of this study was to evaluate the effectiveness and safety of the combination of contact aspiration and stent retriever technique on the rate of reperfusion after mechanical thrombectomy for large vessel occlusion.
Patients who underwent contact aspiration alone (CAA cohort, n = 150), stent retriever alone (SRA cohort, n = 129), or combined contact aspiration and stent retriever (CSR cohort, n = 122) techniques following mechanical thrombectomy were included in the analysis. A balloon guide catheter was used for all thrombectomies. Digital subtraction angiography was used to identify thrombolysis in cerebral infarction.
The number of patients with thrombolysis in cerebral infarction score of ≥ 2c (near complete or complete antegrade reperfusion) was significantly higher in the CSR cohort than those in the CAA cohort (101 [83%] vs. 90 [60%], p < 0.0001) and those of SRA cohort (101 [83%] vs. 77 [59%], p = 0.0001). Arterial perforation was higher in patients in the CSR cohort than in those in the CAA (p < 0.0001) and SRA (p = 0.015) cohorts. Intracerebral hemorrhage was lower in patients in the CSR cohort than in those in the CAA (p = 0.0001) and SRA (p = 0.0353) cohorts. All-cause mortality at 1 year was fewer in the CSR cohort than in the CAA cohort (p = 0.018).
The combination of thrombo aspiration by large bore aspiration catheter and stent retriever is the most effective technique but has some related risks.
IV.
第二代机械血栓切除术中使用的导管具有不同的优缺点。本研究旨在评估接触抽吸联合支架取栓技术在机械血栓切除术后对大血管闭塞再灌注率的有效性和安全性。
纳入接受单纯接触抽吸（CAA 组，n=150）、单纯支架取栓（SRA 组，n=129）或接触抽吸联合支架取栓（CSR 组，n=122）治疗的患者。所有血栓切除术均使用球囊引导导管。数字减影血管造影术用于评估脑梗死溶栓。
CSR 组达到脑梗死溶栓评分≥2c（近乎完全或完全前向再灌注）的患者数量明显多于 CAA 组（101 [83%] 比 90 [60%]，p<0.0001）和 SRA 组（101 [83%] 比 77 [59%]，p=0.0001）。CSR 组的动脉穿孔发生率高于 CAA 组（p<0.0001）和 SRA 组（p=0.015）。CSR 组的颅内出血发生率低于 CAA 组（p=0.0001）和 SRA 组（p=0.0353）。CSR 组的 1 年全因死亡率低于 CAA 组（p=0.018）。
大口径抽吸导管联合支架取栓是最有效的技术，但存在一定的相关风险。
IV。
1。
