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在土耳其使用Thrombite血栓切除术装置治疗前循环大血管闭塞的三年介入神经学经验:安全性、有效性和临床结果。

Three years' interventional neurology experience in Turkey with the Thrombite thrombectomy device in large vessel occlusion in the anterior circulation: safety, efficacy, and clinical outcome.

作者信息

Akpınar Çetin Kürşad, Gurkas Erdem, Ozdemir Atilla Ozcan, Doğan Hasan, Önalan Ayşenur, Yıldırım Serhan, Memiş Zülfikar, Aytaç Emrah, Acar Bilgehan Atılgan, Öğün Muhammed Nur, Aykaç Özlem, Uysal Kocabaş Zehra, Acar Türkan, Eryılmaz Halil Alper, Topaktaş Berkhan

机构信息

Samsun Tranining and Research Hospital, Stroke Center, Department of Neurology, Samsun University, Samsun, Türkiye.

Kartal Dr. Lütfi Kırdar City Hospital, Stroke Center, Department of Neurology, Health Sciences University, İstanbul, Türkiye.

出版信息

Front Neurol. 2024 May 3;15:1320510. doi: 10.3389/fneur.2024.1320510. eCollection 2024.

Abstract

INTRODUCTION

While the Thrombite device differs from the Solitare stent with its Helical open-side structure feature, it shows great similarity with its other features. We assessed the Thrombite device's effectiveness and safety in this study.

MATERIALS AND METHODS

The study was a retrospective analysis of patients who were included in the Turkish Interventional Neurology database and who had mechanical thrombectomy with the Thrombite device as the first choice between January 2020 and January 2023. The type of study is descriptive research.

RESULT

Using the Thrombite thrombectomy device, 525 patients received treatment. The median baseline National Institutes of Health Stroke Scale (NIHSS) score was 13, the median initial Alberta Stroke Program Early Computed Tomography (ASPECT) score was 8, and the mean patient age was 68.6+11.7 years. Between the groin puncture and the successful recanalization, the median time was 34 minutes (interquartile range [IQR]: 15-45). 48.2% (modified treatment in cerebral infarction; mTICI) 2b/3% and 33.9% (mTICI 2c/3) were the first-pass recanalization rates. In the end, 87.7% of patients had effective recanalization (thrombolysis in cerebral infarction 2b/3). In the "first-pass" subgroup, the favorable functional result (modified Rankin Scale 0-2) was 51.8%, while it was 41.6% for the entire patient population. The rate of embolization into new territory/different territory were 2.1/0.1%. 23 patients (4.5%) had symptomatic hemorrhage.

CONCLUSION

The Thrombite device showed a good safety profile and high overall successful recanalization rates in our experience.

摘要

引言

虽然血栓抽吸装置(Thrombite device)因其螺旋开口侧结构特征与Solitaire支架不同,但其其他特征显示出极大的相似性。在本研究中,我们评估了血栓抽吸装置的有效性和安全性。

材料与方法

本研究是对纳入土耳其介入神经病学数据库的患者进行的回顾性分析,这些患者在2020年1月至2023年1月期间以血栓抽吸装置作为首选进行机械取栓。研究类型为描述性研究。

结果

使用血栓抽吸装置对525例患者进行了治疗。基线美国国立卫生研究院卒中量表(NIHSS)评分中位数为13,初始阿尔伯塔卒中项目早期计算机断层扫描(ASPECT)评分中位数为8,患者平均年龄为68.6±11.7岁。从腹股沟穿刺到成功再通的中位时间为34分钟(四分位间距[IQR]:15 - 45)。首次通过再通率为48.2%(改良脑梗死治疗;mTICI)2b/3级和33.9%(mTICI 2c/3级)。最终,87.7%的患者实现了有效再通(脑梗死溶栓2b/3级)。在“首次通过”亚组中,良好功能结局(改良Rankin量表0 - 2级)为51.8%,而在整个患者群体中为41.6%。栓塞至新区域/不同区域的发生率分别为2.1%/0.1%。23例患者(4.5%)发生了症状性出血。

结论

根据我们的经验,血栓抽吸装置显示出良好的安全性和较高的总体成功再通率。

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本文引用的文献

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Mechanical Thrombectomy: Review.机械取栓术:综述
Ann Indian Acad Neurol. 2022 Jul-Aug;25(4):606-615. doi: 10.4103/aian.aian_29_22. Epub 2022 Jun 9.

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