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目的·比较0.014 in的Synchro微导丝和Transend微导丝对急性缺血性脑卒中支架取栓的速度及安全性的影响。方法·入组2012年10月至2017年1月在上海交通大学医学院附属第九人民医院接受机械取栓的急性缺血性卒中患者46例,分为Synchro组(21例)和Transend组(25例),比较2组手术操作时间及安全性等指标。结果·2组闭塞血管再通率类似(P=0.600),但Synchro组从股动脉穿刺至血管再通时间显著短于Transend组(48.88 min vs 82.33 min,P=0.001)。2组患者术后3个月获得功能独立(mRS≤2)的比例类似(P=1.000),操作后蛛网膜下腔出血发生率类似(P=1.000)。但Transend组有2例因血管穿孔导致严重蛛网膜下腔出血伴血肿,均死亡;Synchro组仅有1例轻微的单纯蛛网膜下腔出血,恢复良好。结论·和Transend微导丝相比,Synchro微导丝能够缩短支架取栓操作时间,致命性蛛网膜下腔出血风险较小。
Objective · To compare the effects of 0.014 in Synchro and Transend micro-guidewire on the rate and safety of thrombectomy for acute ischemic stroke. Methods · A total of 46 patients with acute ischemic stroke undergoing mechanical thrombectomy at the Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from October 2012 to January 2017 were divided into the Synchro group (n = 21) and the Transend group (n = 25 cases). The operation time and safety of two groups were compared. Results The rates of reoperation of occlusion in both groups were similar (P = 0.600). However, the duration of reoperation from the femoral artery to reoperation in the Synchro group was significantly shorter than that in the Transend group (48.88 min vs. 82.33 min, P = 0.001). The rates of functional independence (mRS≤2) at 3 months postoperatively were similar in both groups (P = 1.000), with similar rates of postoperative subarachnoid hemorrhage (P = 1.000). However, in Transend group, 2 patients died of serious subarachnoid hemorrhage with hematoma due to perforation of blood vessels. Synchro group had only 1 case of simple subarachnoid hemorrhage and recovered well. Conclusions · Compared with Transend micro-guidewire, Synchro micro-guidewire can shorten the time of stent thrombectomy and has a lower risk of fatal subarachnoid hemorrhage.