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突破12小时时限:一例晚期就诊急性缺血性卒中患者使用支架取栓器进行机械取栓的病例报告

Breaking the 12-hour barrier: A case report on stent-retriever mechanical thrombectomy in a late-presenting acute ischemic stroke.

作者信息

Pandelaki Jacub, Wicaksono Krishna Pandu, Ramandika Heltara, Purba Dessy Natalia, Amelia Rizkya, Ardini Olivia

机构信息

Interventional Radiology Division, Department of Radiology, Dr. Ciptomangunkusumo National General Hospital - Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

Department of Radiology, Dr. Cipto Mangunkusumo National General Hospital - Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.

出版信息

Radiol Case Rep. 2025 May 16;20(8):3840-3845. doi: 10.1016/j.radcr.2025.04.043. eCollection 2025 Aug.

DOI:10.1016/j.radcr.2025.04.043
PMID:40486165
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12143783/
Abstract

Ischemic stroke remains a leading health concern globally, particularly in high-challenge terrains such as Indonesia. Mechanical thrombectomy is one of the main surgical approaches for acute ischemic stroke, and it has significant benefits for patients with viable brain tissue. The pursuit of tissue salvation by mechanical thrombectomy should be maximized through individualized clinical and radiological evaluations. This study presented a 41-year-old man who presented with acute infarct stroke and underwent stent-retriever thrombectomy 12 hours after onset, followed by improvement in speech and motor skills. Key takeaways involve matching clinical data with imaging results, consideration of the benefit of thrombectomy, and striving for the fastest treatment administration.

摘要

缺血性中风仍然是全球主要的健康问题,尤其是在印度尼西亚等高挑战地区。机械取栓术是急性缺血性中风的主要外科治疗方法之一,对具有存活脑组织的患者具有显著益处。应通过个体化的临床和影像学评估,最大限度地利用机械取栓术来挽救组织。本研究介绍了一名41岁男性,他出现急性梗死性中风,发病12小时后接受了支架取栓术,随后言语和运动技能得到改善。关键要点包括将临床数据与影像学结果相匹配、考虑取栓术的益处以及争取最快的治疗实施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/ee1669441df7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/38456e6f2cae/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/417434c1b011/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/e94788e8b27b/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/ee1669441df7/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/38456e6f2cae/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/417434c1b011/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/e94788e8b27b/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39df/12143783/ee1669441df7/gr4.jpg

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本文引用的文献

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Mechanical Thrombectomy in the Late Presentation of Anterior Circulation Large Vessel Occlusion Stroke: A Guideline From the Society of Vascular and Interventional Neurology Guidelines and Practice Standards Committee.前循环大血管闭塞性卒中延迟就诊时的机械取栓术:血管与介入神经病学学会指南与实践标准委员会的指南
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Reperfusion therapy for acute ischemic stroke: where are we in 2023?
急性缺血性脑卒中的再灌注治疗:2023 年我们处于什么位置?
Arq Neuropsiquiatr. 2023 Dec;81(12):1030-1039. doi: 10.1055/s-0043-1777721. Epub 2023 Dec 29.
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Stroke systems of care in South-East Asia Region (SEAR): commonalities and diversities.东南亚地区的卒中照护体系:共性与差异
Lancet Reg Health Southeast Asia. 2023 Oct 9;17:100289. doi: 10.1016/j.lansea.2023.100289. eCollection 2023 Oct.
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Shorter Door-to-Needle Times Are Associated With Better Outcomes After Intravenous Thrombolytic Therapy and Endovascular Thrombectomy for Acute Ischemic Stroke.急性缺血性脑卒中患者接受静脉溶栓治疗和血管内取栓术时,门到针时间越短,结局越好。
Circulation. 2023 Jul 4;148(1):20-34. doi: 10.1161/CIRCULATIONAHA.123.064053. Epub 2023 May 18.
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Stroke Burden and Stroke Services in Indonesia.印度尼西亚的卒中负担和卒中服务。
Cerebrovasc Dis Extra. 2022;12(1):53-57. doi: 10.1159/000524161. Epub 2022 Mar 21.
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