颅内支撑导管联合Solitaire FR取栓支架技术治疗急性大脑中动脉闭塞脑梗死临床观察Clinical observation of SWIM technology in the treatment of cerebral infarction patients with acute middle cerebral artery occlusion
吴海强;李钟安;余庆文;苏瑞林;戚进聪;徐力;方水桥;
摘要(Abstract):
目的分析颅内支撑导管联合Solitaire FR取栓支架(solitaire FR with intracranial support catheter for mechanical thrombectomy,SWIM)技术治疗急性大脑中动脉闭塞脑梗死的安全性、有效性。方法选取2019-05—2020-05湛江中心人民医院神经外二科收治的50例急性大脑中动脉闭塞脑梗死患者为研究对象,行SWIM技术取栓,回顾性分析其临床及影像学资料。结果 50例患者血管再通率92.0%,其中血管完全再通40例,部分再通6例,未通4例。50例患者治疗后NIHSS评分(5.86±2.62)与治疗前(22.09±2.31)比较差异有统计学意义(P<0.05)。50例患者术后90 d m RS与术前比较,差异有统计学意义(t=4.01,P<0.05),其中术后mRS≤2者达60%。结论对急性大脑中动脉闭塞脑梗死患者采用SWIM技术治疗临床疗效良好,安全性高。
关键词(KeyWords): 急性脑梗死;大脑中动脉闭塞;SWIM技术;机械取栓术;安全性
基金项目(Foundation): 2017年湛江市科技局计划项目(编号:2017A01025);; 2020年度湛江市非资助科技攻关计划项目(编号:2020B01271)
作者(Authors): 吴海强;李钟安;余庆文;苏瑞林;戚进聪;徐力;方水桥;
参考文献(References):
- [1]?ZYüNCüN,GüLE?S,G?KSüLüK H,et al.Relationship between silent cerebral infarcts and quality of anticoagulation in patients with prosthetic mitral valves[J].Anatol J Cardiol,2021,25(3):191-195.DOI:10.14744/AnatolJCardiol.2020.57513.
- [2]SARDANA V,SHRINGI P.Neurological Manifestations of Scrub Typhus:A Case Series from Tertiary Care Hospital in Southern East Rajasthan[J].Ann Indian Acad Neurol,2020,23(6):808-811.DOI:10.4103/aian.AIAN_97_19.
- [3]QIAN J,ZAN J,KUANG L,et al.A predictive nomogram of bleeding risk in patients with atrial fibrillation after drug-eluting stent implantation[J].Ann Transl Med,2021,9(3):193.DOI:10.21037/atm-20-3971.
- [4]SHEN X,XIAO S,LIU R,et al.Personalized hypertension management based on serial assessment and telemedicine (PHMA):a cluster randomize controlled trial protocol in Anhui,China[J].BMC Cardiovasc Disord,2021,21(1):135.DOI:10.1186/s12872-021-01943-5.
- [5]FAN L,S U Y,ZHANG Y,et al.Decompressive craniectomy combined with mild hypothermia in patients with large hemispheric infarction:a randomized controlled trial[J].BMC Neurol,2021,21(1):114.DOI:10.1186/s12883-021-02142-7.
- [6]KIMURA T,SAITO S,ANDO K,et al.Final 5-Year Results in Randomized Japanese Patients Implanted With a Thin-Strut,Bioabsorbable,Polymer-Coated,Everolimus-Eluting SYNERGY Stent (From the EVOLVE IIStudy)[J].Circ Rep,2020,3(1):9-17.DOI:10.1253/circrep.CR-20-0114.
- [7]OIKAWA J,FUKAYA H,AKO J,et al.Risk Factors of In-Hospital Lethal Arrhythmia Following Acute Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention-Insight From the J-MINUETStudy[J].Circ Rep,2020,2(1):17-23.DOI:10.1253/circrep.CR-19-0081.
- [8]NISHIHIRA K,KOJIMA S,TAKEGAMI M,et al.Clinical Characteristics and In-Hospital Mortality According to Left Main and Non-Left Main Culprit Lesions-Report From the Japan Acute Myocardial Infarction Registry(JAMIR)[J].Circ Rep,2019,1(12):601-609.DOI:10.1253/circrep.CR-19-0056.
- [9]CHEN S Y,THOMPSON-LEDUC P,SAWYER R N,et al.Outcomes and Resource Use of Patients with Large Hemispheric Infarction and Cerebral Edema:Analysis of Real-world Data[J].Curr Med Res Opin,2021,37(5):781-788.DOI:10.1080/03007995.2021.1900090.
- [10]LU T,YANG X,CAI Y,et al.Prestroke Statins Improve Prognosis of Atrial Fibrillation-Associated Stroke through Increasing Suppressor of Cytokine Signaling-3Levels[J].Eur Neurol,2021,84(2):96-102.DOI:10.1159/000513767.
- [11]SáEZ-ALEGRE M,GARCíA-FEIJOO P,MILLáN P,et al.Case Report:Decompressive Craniectomy for CO-VID-19 Malignant Cerebral Artery Infarction.Is Surgery a Good Option?[J].Front Neurol,2021,12:632036.DOI:10.3389/fneur.2021.632036.
- [12]TAI R,IRIE H,KINUGASA Y,et al.Multiple small tumor formation on both surfaces of the aortic valve cusps in Epstein-Barr virus-associated T/NK-cell lymphoproliferative disease:a case report[J].Gen Thorac Cardiovasc Surg,2021 Mar 13.DOI:10.1007/s11748-021-01613-5.
- [13]TALERICO R,TOSONI A,PILATO F,et al.Cerebral infarction following cyanoacrylate endoscopic therapy of duodenal varices in a patient with a patent foramen ovale:comment[J].Intern Emerg Med,2021 Mar 11.DOI:10.1007/s11739-021-02692-1.
- [14]LEE J,HA J,LEE S K,et al.Feasibility of Iodine-131 6β-Methyl-Iodo-19 Norcholesterol (NP-59) Scintigraphy to Complement Adrenal Venous Sampling in Management of Primary Aldosteronism:A Case Series[J].Int J Gen Med,2021,14:673-680.DOI:10.2147/IJGM.S288774.
- [15]NASSOIY S P,BLACKWELL R H,BROWN M,et al.Development of atrial fibrillation following trauma increases short term risk of cardiovascular events[J].JOsteopath Med,2021 Mar 10.DOI:10.1515/jom-2020-0260.
- [16]LORENTE L,MARTíN M M,GONZáLEZ-RIVERO AF,et al.Serum Levels of B-cell Lymphoma-2 Anti-Apoptotic Protein and Malignant Middle Cerebral Artery Infarction Mortality[J].J Stroke Cerebrovasc Dis,2021,30(5):105717.DOI:10.1016/j.jstrokecerebrovasdis.2021.105717.
- [17]史莉瑾,张雪莹,郭双喜,等.T淋巴细胞亚群水平对急性脑梗死后抑郁的预测价值[J].中国实用神经疾病杂志,2020,23(18):1609-1614.DOI:10.12083/SYSJ.2020.20.001.
- [18]OLUM S,MUYINGO A,WILSON T L,et al.Stroke Mortality Outcomes in Uganda[J].J Stroke Cerebrovasc Dis,2021,30(5):105661.DOI:10.1016/j.jstrokecerebrovasdis.2021.105661.
- [19]KAMEL H,FARRANT M,EASTON J D,et al.Newly Diagnosed Atrial Fibrillation After Transient Ischemic Attack Versus Minor Ischemic Stroke in the POINT Trial[J].J Am Heart Assoc,2021,10(6):e019362.DOI:10.1161/JAHA.120.019362.
- [20]LIU L,ZHANG Q,LI M,et al.Early Post-Stroke Electroacupuncture Promotes Motor Function Recovery in Post-Ischemic Rats by Increasing the Blood and Brain Irisin[J].Neuropsychiatr Dis Treat,2021,17:695-702.DOI:10.2147/NDT.S290148.
- [21]涂加善,刘清华,林瑜,等.急性脑梗死尿激酶静脉溶栓后24h内缺血加重的影响因素分析[J].中国实用神经疾病杂志,2020,23(11):34-38.DOI:10.12083/SYSJ.2020.11.218.
- [22]HUANG D,ZHOU J,LI W,et al.Casticin protected against neuronal injury and inhibited the TLR4/NF-κBpathway after middle cerebral artery occlusion in rats[J].Pharmacol Res Perspect,2021,9(2):e752.DOI:10.1002/prp2.752.
- [23]BHURWANI M,SNYDER K V,WAQAS M,et al.Use of biplane quantitative angiographic imaging with ensemble neural networks to assess reperfusion status during mechanical thrombectomy[J].Proc SPIE Int Soc Opt Eng,2021,11597:115971F.DOI:10.1117/12.2580358.
- [24]ZHOU H,TASHI T,ZHAO D,et al.CT assessment of the increased density of cerebral vessels in plateau region[J].Sci Rep,2021,11(1):5851.DOI:10.1038/s41598-021-85448-3.
- [25]KIM Y,LEE Y B,BAE S K,et al.Development of a photochemical thrombosis investigation system to obtain a rabbit ischemic stroke model[J].Sci Rep,2021,11(1):5787.DOI:10.1038/s41598-021-85348-6.
- [26]SAITO E,INOUE M,SAWADA N,et al.Risk of stroke in cancer survivors using a propensity score-matched cohort analysis[J].Sci Rep,2021,11(1):5599.DOI:10.1038/s41598-021-83368-w.
- [27]王林玉,管生,韩坤强,等.评估分水岭脑梗死患者侧支代偿对早期神经功能的影响[J].中国实用神经疾病杂志,2019,22(13):12-17.DOI:10.12083/SYSJ.2019.13.198.
- [28]GARCíA-TORNELá,CAMPOS D,RUBIERA M,et al.Ischemic Core Overestimation on Computed Tomography Perfusion[J].Stroke,2021,52(5):1751-1760.DOI:10.1161/STROKEAHA.120.031800.
- [29]LIAO F F,LIN G,CHEN X,et al.Endothelial nitric oxide synthase deficient mice:a model of spontaneous cerebral small vessel disease[J].Am J Pathol,2021,10:S0002-9440 (21) 00102-4.DOI:10.1016/j.ajpath.2021.02.022.
- [30]袁佳欣,陈琦,窦连伟,等.脑钠肽与急性脑梗死及脑梗死静脉溶栓的相关性研究进展[J].中国实用神经疾病杂志,2019,22(1):112-116.DOI:10.12083/SYSJ.2019.01.022.