[1]顾一名,曹月洲,王 斌,等.急性缺血性脑卒中支架取栓首次成功再灌注的影响因素分析[J].介入放射学杂志,2022,31(03):226-229.
 GU Yiming,CAO Yuezhou,WANG Bin,et al.Analysis of the factors influencing the first pass reperfusion in Solitaire stent thrombectomy for acute ischemic stroke[J].journal interventional radiology,2022,31(03):226-229.
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急性缺血性脑卒中支架取栓首次成功再灌注的影响因素分析()

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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
31
期数:
2022年03
页码:
226-229
栏目:
神经介入
出版日期:
2022-03-25

文章信息/Info

Title:
Analysis of the factors influencing the first pass reperfusion in Solitaire stent thrombectomy for acute ischemic stroke
作者:
顾一名 曹月洲 王 斌 赵林波 贾振宇 施海彬 刘 圣
Author(s):
GU Yiming CAO Yuezhou WANG Bin ZHAO Linbo JIA Zhenyu SHI Haibin LIU Sheng.
Department of Interventional Radiology, First Affiliated Hospital of Nanjing Medical University. Nanjing, Jiangsu Province 210029, China
关键词:
【关键词】 急性缺血性脑卒中 支架取栓 首次成功再灌注 影响因素
文献标志码:
A
摘要:
【摘要】 目的 探讨前循环急性缺血性脑卒中(AIS)患者支架取栓术首次成功再灌注(FPR)的影响因素。方法 回顾性分析2018年1月至2020年3月在南京医科大学第一附属医院接受Solitaire AB支架取栓治疗的前循环AIS患者临床资料。根据首次支架取栓后闭塞血管再通程度是否达到改良溶栓治疗脑梗死(mTICI)血流分级2c/3级且无需补救措施,将患者分为FPR组和非FPR组。采用单因素分析和多因素logistic回归法分析FPR相关影响因素。结果 共纳入215例患者,其中FPR组61例(28.4%),非FPR组154例(71.6%)。单因素分析显示,FPR组患者平均穿刺至再通时间、90 d良好预后率均优于非FPR组(P<0.05)。多因素logistic回归分析显示,大脑中动脉闭塞(OR=0.387,95%CI=0.180~0.834,P=0.015)、术前静脉溶栓(OR=0.410,95%CI=0.214~0.787,P=0.007)、取栓过程中使用中间导管(OR=0.405,95%CI=0.209~0.787,P=0.008)是FPR的独立预测因素。结论 FPR与大血管闭塞性AIS患者临床良好预后相关。支架取栓过程中大脑中动脉闭塞、使用中间导管及术前行静脉溶栓,会增加FPR可能性。

参考文献/References:

[1] 霍晓川,高 峰. 急性缺血性卒中血管内治疗中国指南2018[J]. 中国卒中杂志, 2018, 13:706- 729.
[2] Ducroux C, Piotin M, Gory B, et al. First pass effect with contact aspiration and stent retrievers in the Aspiration versus Stent Retriever(ASTER) trial[J]. J Neurointerv Surg, 2020, 12: 386- 391.
[3] Lee JS, Hong JM, Kim JS. Diagnostic and therapeutic strategies for acute intracranial atherosclerosis- related occlusions[J]. J Stroke, 2017, 19: 143- 151.
[4] Zaidat OO, Yoo AJ, Khatri P, et al. Recommendations on angiographic revascularization grading standards for acute ischemic stroke: a consensus statement[J]. Stroke, 2013, 44: 2650- 2663.
[5] Di Maria F, Kyheng M, Consoli A, et al. Identifying the predictors of first- pass effect and its influence on clinical outcome in the setting of endovascular thrombectomy for acute ischemic stroke: results from a multicentric prospective registry[J]. Int J Stroke, 2021, 16: 20- 28.
[6] Bernsen M, Goldhoorn RB, Lingsma HF, et al. Importance of occlusion site for thrombectomy technique in stroke: comparison between aspiration and stent retriever[J]. Stroke, 2021, 52: 80- 90.
[7] Kamalian S, Morais LT, Pomerantz SR, et al. Clot length distri-bution and predictors in anterior circulation stroke implications for intra- arterial therapy[J]. Stroke, 2013, 44: 3553- 3556.
[8] Goyal N, Tsivgoulis G, Pandhi A, et al. Impact of pretreatment with intravenous thrombolysis on reperfusion status in acute strokes treated with mechanical thrombectomy[J]. J Neurointerv Surg, 2019, 11: 1073- 1079.
[9] Mistry EA, Mistry AM, Nakawah MO, et al. Mechanical throm-bectomy outcomes with and without intravenous thrombolysis in stroke patients: a meta- analysis[J]. Stroke, 2017, 48: 2450- 2456.
[10] Fischer U, Kaesmacher J, Molina CA, et al. Primary thrombectomy in tPA(tissue- type plasminogen activator)eligible stroke patients with proximal intracranial occlusions[J]. Stroke, 2018, 49: 265- 269.
[11] Lapergue B, Labreuche J, Blanc R, et al. Combined use of contact aspiration and the stent retriever technique versus stent retriever alone for recanalization in acute cerebral infarction: the randomized ASTER 2 study protocol[J]. J Neurointerv Surg, 2020, 12: 471- 476.
[12] 李 强,朱良付,周腾飞,等. SWIM技术在大脑中动脉急性闭塞治疗中的应用[J]. 介入放射学杂志, 2019, 28:717- 720.
[13] 瞿小锋,李沛城,范伟健,等. 机械取栓治疗心源性和非心源性急性脑卒中有效性和安全性对比分析[J]. 介入放射学杂志, 2019, 28:721- 725. 

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备注/Memo

备注/Memo:
(收稿日期:2021- 02- 20)
(本文编辑:边 佶)
更新日期/Last Update: 2022-03-17