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Acute intracranial stenting with mechanical thrombectomy is safe and efficacious in patients diagnosed with underlying intracranial atherosclerotic disease
Interventional Neuroradiology ( IF 1.7 ) Pub Date : 2021-09-13 , DOI: 10.1177/15910199211039403
Ameer E Hassan 1, 2, 3 , Victor M Ringheanu 2 , Laurie Preston 2, 3 , Wondwossen G Tekle 1, 3 , Adnan I Qureshi 4, 5
Affiliation  

Objective

To investigate whether significant differences exist in recanalization rates and primary outcomes between patients who undergo mechanical thrombectomy alone versus those who undergo mechanical thrombectomy with acute intracranial stenting.

Methods

Through the utilization of a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2020, variables such as demographics, co-morbid conditions, symptomatic intracerebral hemorrhage, mortality rate at discharge, and good/poor outcomes in regard to modified thrombolysis in cerebral infarction score and modified Rankin Scale were examined. The outcomes between patients receiving acute intracranial stenting + mechanical thrombectomy and patients that underwent mechanical thrombectomy alone were compared.

Results

There were a total of 420 acute ischemic stroke patients who met criteria for the study (average age 70.6 ± 13.01 years; 46.9% were women). Analysis of 46 patients from the acute stenting + mechanical thrombectomy group (average age 70.34 ± 13.75 years; 37.0% were women), and 374 patients from the mechanical thrombectomy alone group (average age 70.64 ± 12.92 years; 48.1% were women). Four patients (8.7%) in the acute stenting + mechanical thrombectomy group experienced intracerebral hemorrhage versus 45 patients (12.0%) in the mechanical thrombectomy alone group (p = 0.506); no significant increases were noted in the median length of stay (7 vs 8 days; p = 0.208), rates of modified thrombolysis in cerebral infarction 2B-3 recanalization (p = 0.758), or good modified Rankin Scale scores (p = 0.806).

Conclusion

Acute intracranial stenting in addition to mechanical thrombectomy was not associated with an increase in overall length of stay, intracerebral hemorrhage rates, or any change in discharge modified Rankin Scale. Further research is required to determine whether mechanical thrombectomy and acute intracranial stenting in acute ischemic stroke patients is unsafe.



中文翻译:

对于诊断患有潜在颅内动脉粥样硬化疾病的患者,急性颅内支架植入联合机械血栓切除术是安全有效的

客观的

旨在研究仅接受机械血栓切除术的患者与接受机械血栓切除术联合急性颅内支架置入术的患者之间的再通率和主要结局是否存在显着差异。

方法

通过利用 2012 年至 2020 年间综合性卒中中心前瞻性收集的血管内数据库,研究了人口统计学、合并症、症状性脑出血、出院死亡率以及脑改良溶栓治疗的良好/不良结果等变量。检查梗塞评分和改良Rankin量表。比较接受急性颅内支架置入+机械取栓术的患者与单独接受机械取栓术的患者的结果。

结果

共有 420 名符合研究标准的急性缺血性中风患者(平均年龄 70.6 ± 13.01 岁;46.9% 为女性)。分析了急性支架置入+机械取栓组的 46 名患者(平均年龄 70.34 ± 13.75 岁;37.0% 为女性)和单纯机械取栓组的 374 名患者(平均年龄 70.64 ± 12.92 岁;48.1% 为女性)。急性支架植入+机械取栓组有 4 名患者(8.7%)出现脑出血,而单纯机械取栓组有 45 名患者(12.0%)发生脑出血(p  = 0.506);中位住院时间(7 天 vs 8 天;p  = 0.208)、脑梗死 2B-3 改良溶栓再通率(p  = 0.758)或良好的改良 Rankin 量表评分(p  = 0.806)没有显着增加。

结论

除机械血栓切除术外,急性颅内支架置入术与总住院时间、脑出血发生率或出院改良Rankin量表的任何变化的增加无关。需要进一步的研究来确定机械血栓切除术和急性颅内支架置入术对急性缺血性中风患者是否不安全。

更新日期:2021-09-13
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