Nyob rau hauv xyoo tas los no, thrombectomy rau mob stroke tau dhau los ua lub ntsiab lus kub hauv thaj tsam ntawm neurointervention. Yog li, kev xaiv ntawm kev kho mob rau kev mob stroke ischemic tau dhau los ua qhov tseem ceeb. Raws li cov txheej txheem tshiab vascular aspiration, ADAPT tau nyiam ntau thiab ntau dua vim nws qhov zoo ntawm kev ua haujlwm yooj yim, qhib nrawm ntawm cov hlab ntsha, kev ua tiav siab ntawm vascular qhib, thiab tsawg dua kev puas tsuaj rau cov ntaub so ntswg.
ADAPT thev naus laus zis muaj txiaj ntsig zoo hauv kev kho mob ntawm cov kab mob loj heev.
ADAPT thev naus laus zis yog "Direct Aspiration First Pass Technique" (Ib Txoj Kev Ncaj Ncees Ua Ntej Ua Ntej, ADAPT). Cov txheej txheem ADAPT siv cov txheej txheem traceable, tsis cuam tshuam, thiab loj-ntev nruab nrab catheter ua cov txheej txheem thawj kab rau kev ncaj qha aspiration thiab thrombectomy. Tam sim no nws yog ib txoj hauv kev phais rau vascular recanalization nyob rau hauv mob ischemic stroke.
Hauv cov lus qhia tshiab ntawm AHA/ASA hauv 2019, ADAPT thev naus laus zis tau suav tias yog IB-theem pom zoo kho, uas muab pov thawj muaj zog rau kev siv dav dav ntawm ADAPT hauv kev kho mob. Nrog kev tshaj tawm ntawm ob qhov txiaj ntsig ntawm ASTER thiab COMPASS, ADAPT tau qhia txog kev nyab xeeb zoo sib xws thiab kev ua haujlwm zoo rau stent thrombectomy, thiab ntau thiab ntau tus kws kho mob neurointerventional tau pib siv cov thev naus laus zis no ua thawj kab kev kho mob.
Hauv kev kho mob loj heev intracranial thrombus, ADAPT thev naus laus zis muaj txiaj ntsig zoo. Lub pathogenesis ntawm cov neeg mob uas hnyav thrombus load feem ntau yog cardiogenic emboli. Cov hlab ntsha loj carotid atherosclerosis nrog stenosis yog ib hom mob stroke loj. Atrial fibrillation muaj cov teebmeem sib txawv ntawm ntau hom ischemic stroke. Ntawm lawv, atrial fibrillation Cardiac stroke account rau ntau tshaj plaws.
Nyob rau hauv M1, M2, thiab txawm M3 ntu ntawm nruab nrab cerebral hlab ntsha, tej zaum yuav muaj ib co emboli nyob rau thaum xaus ntawm lub bifurcation los yog sab hauv tsev menyuam ntu nrog ib tug kuj loj load. Ua ntej ADAPT thev naus laus zis tawm los, tus nqi canalization ntawm cov emboli yog tsawg dua 50 feem pua. Cov muaj pes tsawg leeg ntawm emboli loj load yog complex, load ntawm emboli loj, thiab qhov hnyav ntawm emboli daig nyob rau hauv cov hlab ntsha yog txawv. Siv ADAPT thev naus laus zis tuaj yeem nqus tau qee qhov emboli loj thiab tib lub sijhawm ua lub luag haujlwm hauv kev txo qis ntawm qhov distal emboli. Lub microguide hlau microcatheter tseem ua lub luag haujlwm pabcuam hauv kev ncav cuag qhov kawg.
Rau cov neeg mob uas hnyav thrombus hnyav, qhov qhib ntawm thrombectomy ib leeg yog tsawg dua 50 feem pua, tab sis yog tias ua ke nrog ADAPT thev naus laus zis, tus nqi canalization yuav ze li 70 feem pua -80 feem pua , thiab qee lub chaw txawm mus txog tus nqi recanalization. ntawm 90 feem pua. Cov neeg mob uas muaj lub nra loj ntawm thrombus nyob rau hauv lub anterior ncig yog tag nrho cov cardiogenic emboli, thiab lub compensatory muaj nuj nqi ntawm tag nrho cov unilateral anterior ncig system yog heev tsis zoo, thiab kev tuag thiab kev tsis taus tus nqi ntawm cov neeg mob no siab heev. Siv ADAPT ua ke nrog stent thrombectomy thev naus laus zis, lub voj voog sab hauv tuaj yeem qhib tau sai thiab zoo, thiab lub sijhawm qhib yog luv heev, thiab qee qhov tuaj yeem ua tiav hauv ib nrab teev xwb.
Kev nce qib ntawm kev kho mob thev naus laus zis yog sib cais los ntawm kev tsim kho tshiab thiab txhim kho cov ntaub ntawv. ADAPT thev naus laus zis tau siv dav hauv kev kho mob vascular recanalization ntawm tus kab mob ischemic cerebrovascular. Cov kev tshawb fawb yav dhau los tau pom tias kev siv cov catheter loj loj tuaj yeem txo lub sijhawm los ntawm kev sib tsoo mus rau cov hlab ntsha recanalization, nce tus nqi ntawm kev ua tiav rov qab tom qab ib qho kev ntshaw, thiab txo qis kev siv cov kev pab stent. Qhov tshwm sim ntawm aspiration catheters tau hloov cov cwj pwm thrombectomy ntawm cov kws kho mob neurointerventional, tsis tsuas yog ua kom thrombectomy smoother, tab sis kuj ua rau ntau txoj kev phais mob yooj yim dua.