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多区域 NeVa 支架取栓器在缺血性脑卒中机械取栓中的有效性和安全性评估。

Evaluation of effectiveness and safety of the multizone NeVa stent retriever for mechanical thrombectomy in ischemic stroke.

机构信息

Clinic for Radiology, University of Muenster and University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.

Clinic for Radiology and Neuroradiology, Alfried Krupp Hospital, Essen, Germany.

出版信息

Neuroradiology. 2023 Dec;65(12):1777-1785. doi: 10.1007/s00234-023-03236-4. Epub 2023 Oct 25.

Abstract

PURPOSE

This study aimed to evaluate the effectiveness and safety of the NeVa stent retriever as first- and second-line device for mechanical thrombectomy in acute ischemic stroke.

METHODS

In this retrospective single-center study, all consecutive patients that underwent mechanical thrombectomy with NeVa stent retriever as first- or second-line device due to intracranial vessel occlusion with acute ischemic stroke between March and November 2022 were included.

RESULTS

Thirty-nine patients (m=18, f=21) with a mean age of 69.9 ± 13.3 years were treated with the NeVa stent retriever. NeVa stent retriever was used as first-line device in 24 (61.5%) of patients and in 15 (38.5%) as second-line device. First-pass rate (≥mTICI 2c) of NeVa stent retriever was both 66.7% when used as first- or second-line device. Final recanalization rate including rescue strategies was 92.3% for ≥mTICI2c and 94.9% for ≥mTICI2b. No device-related minor or major adverse events were observed. A hemorrhage was detected in 33.3% of patients at 24h post-thrombectomy dual-energy CT, of which none was classified as symptomatic intracerebral hemorrhage. NIHSS and mRS improved significantly at discharge compared to admission (p<0.05).

CONCLUSION

The NeVa stent retriever has a high effectivity and good safety profile as first- and second-line device for mechanical thrombectomy in acute ischemic stroke.

摘要

目的

本研究旨在评估 NeVa 支架取栓器作为急性缺血性脑卒中机械取栓的一线和二线设备的有效性和安全性。

方法

在这项回顾性单中心研究中,所有连续因颅内血管闭塞而接受 NeVa 支架取栓器作为一线或二线设备治疗的急性缺血性脑卒中患者均被纳入研究。

结果

39 名患者(男性 18 例,女性 21 例),平均年龄为 69.9±13.3 岁,接受了 NeVa 支架取栓器治疗。NeVa 支架取栓器作为一线设备在 24 例(61.5%)患者中使用,在 15 例(38.5%)患者中作为二线设备使用。作为一线或二线设备使用时,NeVa 支架取栓器的首次通过率(≥mTICI 2c)均为 66.7%。包括挽救策略在内的最终再通率为≥mTICI2c 为 92.3%,≥mTICI2b 为 94.9%。未观察到与器械相关的轻微或重大不良事件。在血栓切除术 24 小时后进行的双能 CT 检查中,33.3%的患者发现出血,其中无一例被归类为症状性颅内出血。与入院时相比,出院时 NIHSS 和 mRS 显著改善(p<0.05)。

结论

NeVa 支架取栓器作为急性缺血性脑卒中机械取栓的一线和二线设备具有较高的有效性和良好的安全性。

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