Tam sim no, ntau qhov kev tshawb fawb soj ntsuam thoob ntiaj teb tau lees paub tias stent thrombectomy tuaj yeem pab cov neeg mob uas mob stroke ischemic. Nyob rau hauv xyoo tas los no, cov tswv yim aspiration thrombectomy kuj tau siv ntau hauv kev kho mob, tshwj xeeb tshaj yog cov txheej txheem ncaj qha aspiration (ADAPT) siv cov catheter loj-ntev nruab nrab. ADAPT muaj tus nqi recanalization ntau dua thiab lub sij hawm canalization luv dua li thawj qhov kev xaiv ntawm stent retriever thrombectomy. Qhov tshwm sim ntawm ADAPT thev naus laus zis ua rau thrombectomy yooj yim dua thiab yooj yim dua.
Lub hauv paus ntsiab lus ntawm ADAPT yog xa cov catheter loj rau qhov chaw ntawm lub thrombus, thiab tom qab ntawd siv qhov nqus kom tshem tawm cov thrombus. Nws qhov tshwm sim muab cov kws kho mob muaj kev nyab xeeb thiab nrawm nrawm. Tham txog qhov zoo ntawm ADAPT thev naus laus zis hauv kev kuaj mob thiab kho mob stroke ischemic stroke, los ntawm kev kho mob, ADAPT thev naus laus zis yog luv luv hauv lub sijhawm, muaj tus nqi recanalization siab, qis embolus khiav tawm tus nqi thiab tsis tshua muaj teeb meem, thiab yog ib qho kev kho mob zoo tshaj plaws rau kev mob ischemic. mob stroke. kev xaiv zoo tshaj plaws.
High recanalization tus nqi
ADAPT thev naus laus zis muaj qhov ua kom rov zoo dua qub, tshwj xeeb tshaj yog rau kev kho mob ntawm qhov kawg ntawm cov hlab ntsha carotid sab hauv lossis loj-burden thrombus kawg ntawm cov hlab ntsha basilar. Rau cov neeg mob hnyav thrombus, kev kho ob-stent feem ntau tau siv yav dhau los, tab sis tus nqi patency tsis siab thiab muaj cov kev mob tshwm sim ntawm vascular puas tsuaj. Ntawm qhov tod tes, tus nqi ntawm kev kho ob-stent kuj tseem siab. Qhov tshwm sim ntawm ADAPT thev naus laus zis tau ua kom zoo dua qub ntawm cov hlab ntsha.
Lub sij hawm siv
Lub sijhawm yog qhov tseem ceeb. Rau qhov hnyav thrombus, nws siv sijhawm ntev los siv ob lub stents rub los ntawm thrombus, thiab nws yuav tsum tau rov ua ntau zaus. Nrog rau ADAPT thev naus laus zis, kev xav tau nrawm heev, thiab ntau qhov txhab tuaj yeem ua tiav hauv kaum lossis nees nkaum feeb xwb. ADAPT thev naus laus zis yog qhov kev txhim kho zoo hauv lub sijhawm nws siv los qhib cov hlab ntsha.
Tsawg embolus khiav tawm tus nqi
Yav dhau los, thaum rub lub thrombus, lub microguidewire thiab microcatheter yuav tsum tau hla qhov chaw thrombus occlusion, yog li nws yooj yim rau embolus kom khiav tawm thaum lub sijhawm rub tawm. Txawm li cas los xij, nrog kev siv ADAPT thev naus laus zis, tom qab xaiv qhov tseeb microcatheter, tsis tas yuav hla qhov chaw thrombus occlusion. Aspiration yog ua ncaj qha los ntawm qhov chaw occlusion ntawm lub embolus, zoo heev txo qhov tshwm sim ntawm distal embolus khiav.
Yooj yim rau siv
Siv ADAPT los qhib qhov occlusion ntawm M1 ntu tsis tas yuav dhau los ntawm qhov chaw occlusion, thiab nws tsis tas yuav mus txog qhov kawg ntawm qhov kawg thaum nqus cov catheter, uas txo qhov nyuaj ntawm kev ua haujlwm. Rau tus neeg teb xov tooj, ADAPT ua rau thrombectomy yooj yim dua thiab yooj yim dua. Qhov yooj yim dua.
Saib rov qab ntawm keeb kwm ntawm kev kho mob ntawm tus mob ischemic stroke, txij li xyoo 1995, cov txheej txheem kev kho mob thoob ntiaj teb tau pom zoo thrombolytic kho raws li thawj txoj kev pom zoo hauv kev kho cov neeg mob mob stroke. Hauv xyoo 2015, tsib qhov kev sim tshuaj endovascular mob stroke tseem ceeb tau tshaj tawm, lees paub tias cov neeg mob stroke tshwm sim los ntawm cov hlab ntsha loj occlusion tuaj yeem tau txais txiaj ntsig los ntawm kev kho mob endovascular. Qhov kev kawm tseem ceeb no tau tsim tsa lub luag haujlwm ntawm txhua yam thrombectomy hauv cov hlab ntsha loj occlusion. Thawj-kab kev kho mob qhia txog qhov tuaj txog ntawm lub sijhawm ntawm thrombectomy.
Hauv ob xyoos dhau los, nrog kev tshwm sim ntawm ADAPT thev naus laus zis, stent thrombectomy lossis catheter aspiration tau dhau los ua lub ntsiab lus kub uas tau tham dav dav hauv kev kho mob. 2019 AHA/ASA cov lus qhia hloov tshiab teev ADAPT thev naus laus zis raws li kev kho mob IB tau pom zoo, muab pov thawj muaj zog txhawb rau kev siv tshuaj kho mob ntawm ADAPT thev naus laus zis
Nws tuaj yeem pom los ntawm tag nrho cov keeb kwm kev vam meejtias mechanical thrombectomy tau maj mam nce nrog kev txhim kho cov khoom siv. Kuv ntseeg tias nrog kev txhim kho ntawm cov ntaub ntawv, kev tshawb fawb tshiab, thiab kev txo nqi hauv cheeb tsam, ADAPT thev naus laus zis yuav yog qhov kev txhim kho tsis pom kev hauv kev kho mob xwm txheej ceev yav tom ntej.