CAJ | 학술논문

目的：探讨应用机械取栓装置Solitaire AB治疗颅内动脉远端闭塞所致前循环急性缺血性卒中的效果。方法回顾性分析采用Solitaire AB取栓装置治疗的9例前循环远端动脉闭塞患者的资料，其中大脑中动脉M2段闭塞7例，大脑前动脉A3段闭塞2例。分析9例患者的临床特征、影像学资料、治疗及术后3个月临床随访结果。以支架取栓后再通率、治疗前后美国国立卫生研究院卒中量表（NIHSS）评分及术后3个月随访时改良Rankin量表（mRS）评分评估治疗的有效性，以手术相关并发症、病死率评估治疗的安全性。结果（1）9例患者中，8例成功再通，改良脑梗死溶栓试验（mTICI）分级2b或3级。（2）出院时 NIHSS评分中位数9.5（3.0，15.5）分，较术前19.0（16.0，22.0）分明显下降（Z＝2.703，P＝0.007），未发生操作相关永久性并发症。再通的8例患者中，4例预后良好（mRS评分为0～1分），4例残疾（mRS评分为3～4分）；未再通的1例患者术后3个月随访时mRS评分为4分。结论颅内动脉M2段或A3段急性闭塞时，使用Solitaire AB取栓效果较好，其有效性、安全性及适应证尚需更大样本的对照研究进一步探索。
목적：탐토응용궤계취전장치Solitaire AB치료로내동맥원단폐새소치전순배급성결혈성졸중적효과。방법회고성분석채용Solitaire AB취전장치치료적9례전순배원단동맥폐새환자적자료，기중대뇌중동맥M2단폐새7례，대뇌전동맥A3단폐새2례。분석9례환자적림상특정、영상학자료、치료급술후3개월림상수방결과。이지가취전후재통솔、치료전후미국국립위생연구원졸중량표（NIHSS）평분급술후3개월수방시개량Rankin량표（mRS）평분평고치료적유효성，이수술상관병발증、병사솔평고치료적안전성。결과（1）9례환자중，8례성공재통，개량뇌경사용전시험（mTICI）분급2b혹3급。（2）출원시 NIHSS평분중위수9.5（3.0，15.5）분，교술전19.0（16.0，22.0）분명현하강（Z＝2.703，P＝0.007），미발생조작상관영구성병발증。재통적8례환자중，4례예후량호（mRS평분위0～1분），4례잔질（mRS평분위3～4분）；미재통적1례환자술후3개월수방시mRS평분위4분。결론로내동맥M2단혹A3단급성폐새시，사용Solitaire AB취전효과교호，기유효성、안전성급괄응증상수경대양본적대조연구진일보탐색。
Objective To investigate the effect of mechanical thrombectomy device Solitaire AB for the treatment of distal occlusion of the intracranial artery caused acute anterior circulation ischemic stroke. Methods The clinical data of 9 patients with arterial occlusion of distal anterior circulation treated by using the Solitaire AB thrombectomy device were analyzed retrospectively. Seven of them had M2 middle cerebral artery occlusion and 2 had A3 occlusion. Their clinical features,imaging data,treatment,and the results of 3-month clinical follow-up were analyzed. The effectiveness of treatment was evaluated through the recanalization rate after stent thrombectomy,the National Institutes of Health Stroke Scale (NIHSS)scores before and after treatment,the modified Rankin scale (mRS)scores,and the 3-month clinical follow-up results. The surgery-related complications and mortality of patients were used to evaluate the safety of the treatment. Results (1 )Of the 9 intracranial arterial occlusions,8 were recanalized successfully. The modified thrombolysis in cerebral infarction (mTICI)was 2b or grade 3. (2)The NIHSS score median 9. 5 (3. 0,15. 5)at discharge dropped significantly compared with 19. 0 (16. 0,22. 0)before procedure. (Z=2. 703,P=0. 007). No permanent complications related to operation occurred. Four of the recanalized patients had good prognosis (mRS 0-1)and 4 had disability (mRS 3-4 ). The mRS score of one non-recanalized patient was 4 at the 3 months follow-up. Conclusion The embolectomy effect is good whom using Solitaire AB device for acute occlusion occurred in the intracranial artery M2 or A3 segment. Its efficacy,safety,and indications still need to be further explored in a larger sample controlled trial.