Dorn Franziska, Voss Yves Leonard, Zidan Mousa, Neuhaus Stephanie, Lehnen Nils, Stracke Paul, Schwindt Wolfram, Ergawy Mostafa, Dyzmann Christian, Moehlenbruch Markus, Jesser Jessica, Vollherbst Dominik, Moreu Manuel, Pérez-García Carlos, Bester Maxim, Flottmann Fabian, Simgen Andreas, Schob Stefan, Berlis Ansgar, Maurer Christoph, Buhk Jan Hendrik, Hentschel Hannah, Loehr Christian, Eckert Bernd, Saura Javier, Delgado Fernando, Paech Daniel, Nordmeyer Hannes
Department of Neuroradiology, University Hospital of Bonn, Bonn, Germany.
Department of Diagnostic and Interventional Neuroradiology, Städtisches Klinikum Solingen, Solingen, Germany.
Clin Neuroradiol. 2025 Mar;35(1):43-50. doi: 10.1007/s00062-024-01448-6. Epub 2024 Aug 23.
Rescue intracranial stenting is necessary to provide sufficient recanalization after mechanical thrombectomy (MT) in patients with acute large vessel occlusions (LVO) due to an underlying intracranial atherosclerotic disease (ICAD). The CREDO heal is a novel stent that provides a potentially lower thrombogenicity due to surface modification. We present the first multicentric experience with the CREDO heal for acute rescue stenting.
Data of 81 patients who underwent rescue stenting after MT at 12 centers in Germany and Spain were prospectively collected and retrospectively evaluated.
Final mTICI 2b‑3 was reached in 95.1% after median two MT maneuvers and stenting. Four periprocedural complications resulted in clinical deterioration (4.9%). Intraparenchymal hemorrhage occurred in one patient (1.2%) and functional independence at FU was reached by 42% of the patients. Most interventions were performed under Gp IIb/IIIa inhibitors.
CREDO heal was effective and safe in our case series. However, more data is needed to define the optimal antithrombotic regime. The use under single antiplatelet medication is not supported by our study.
对于因潜在颅内动脉粥样硬化疾病（ICAD）导致急性大血管闭塞（LVO）的患者，在机械取栓（MT）后进行补救性颅内支架置入术以实现充分再通是必要的。CREDO heal是一种新型支架，因其表面改性而具有潜在的较低血栓形成性。我们展示了首次使用CREDO heal进行急性补救性支架置入术的多中心经验。
前瞻性收集并回顾性评估了德国和西班牙12个中心81例在MT后接受补救性支架置入术患者的数据。
经过中位两次MT操作和支架置入术后，95.1%的患者达到了最终mTICI 2b-3。4例围手术期并发症导致临床恶化（4.9%）。1例患者发生脑实质内出血（1.2%），42%的患者在随访时达到功能独立。大多数干预措施是在糖蛋白IIb/IIIa抑制剂的作用下进行的。
在我们的病例系列中，CREDO heal是有效且安全的。然而，需要更多数据来确定最佳抗血栓治疗方案。我们的研究不支持在单一抗血小板药物治疗下使用。
