Abstract
Mechanical thrombectomy yog ib qho kev kho mob zoo heev rau mob ischemic stroke tshwm sim los ntawm arterial occlusion nyob rau hauv lub anterior ncig. Aspiration catheter ncav cuag thrombus (ARTS) kos npe yog ib qho kev ntsuas tshiab uas txiav txim siab txog qhov twg ntawm thrombus aspiration thaum lub tshuab thrombectomy. Lub hom phiaj ntawm qhov kev tshuaj xyuas no yog txhawm rau ntsuas qhov cuam tshuam ntawm ARTS kos npe rau hauv cov txheej txheem ua ke rau kev kho tshuab thrombectomy ntawm thawj-pass tiav reperfusion.
Taw qhia
Stroke yog ib qho ua rau mob thiab tuag thoob ntiaj teb. Mob stroke ischemic mob rau kwv yees li 80% ntawm tag nrho cov mob stroke thiab yog tshwm sim los ntawm cerebral arterial occlusion. Mechanical thrombectomy tau hloov kho kev kho mob ntawm ischemic stroke tshwm sim los ntawm arterial occlusion nyob rau hauv lub anterior ncig. Tus qauv tam sim no ntawm kev saib xyuas rau cov neeg kho tshuab thrombectomy yog kev xa tawm ntawm cov khoom siv stent retriever. Txawm li cas los xij, kev siv stent retriever feem ntau cuam tshuam nrog kev ua tsis tiav reperfusion, uas tuaj yeem ua rau cov txiaj ntsig tsis zoo. Txhawm rau txhim kho tus nqi ntawm kev ua kom tiav reperfusion, cov txheej txheem sib xyaw ua ke, uas suav nrog kev siv stent retriever thiab ib qho aspiration catheter, tau tsim.
Aspiration catheter ncav cuag thrombus (ARTS) kos npe yog ib qho kev ntsuas tshiab uas txiav txim siab txog qhov twg ntawm thrombus aspiration thaum lub tshuab thrombectomy. ARTS kos npe yog txhais tau tias muaj qhov tsis muaj qhov tsis pom kev lossis tsis muaj qhov sib txawv ntawm cov xov xwm sib txawv hauv lub tshuab raj aspiration thaum thawj ob peb vib nas this ntawm kev xav tom qab lub catheter tip hu rau thrombus.
Impact of ARTS Sign in Combined Technique for Mechanical Thrombectomy on First-Pass Complete Reperfusion
Ntau qhov kev tshawb fawb tau soj ntsuam qhov cuam tshuam ntawm ARTS kos npe rau hauv cov txheej txheem ua ke rau kev kho mob thrombectomy ntawm thawj-pass tiav reperfusion. Hauv kev tshawb nrhiav rov qab ntawm 127 tus neeg mob, qhov zoo ntawm ARTS kos npe tau cuam tshuam nrog tus nqi siab dua ntawm thawj zaug ua tiav reperfusion (71.4% vs 34.7%, p.<0.001) and a lower rate of embolization to new territories (0.8% vs 13.8%, p=0.021) compared to a negative ARTS sign. In another retrospective study of 95 patients, a positive ARTS sign was associated with a higher rate of first-pass complete reperfusion (81.6% vs 47.1%, p=0.001) and a lower rate of multiple retrieval attempts (13.4% vs 42.9%, p<0.001) compared to a negative ARTS sign.
Qhov cuam tshuam ntawm ARTS kos npe rau hauv cov txheej txheem ua ke rau kev kho mob thrombectomy ntawm cov txiaj ntsig kho mob kuj tau raug soj ntsuam. Hauv kev tshawb nrhiav rov qab ntawm 180 tus neeg mob, qhov zoo ARTS kos npe tau cuam tshuam nrog tus nqi qis ntawm cov tsos mob intracranial hemorrhage (8.7% vs 28.8%, p=0.007) thiab tus nqi siab dua ntawm kev ywj pheej ua haujlwm (hloov Rankin Scale qhab nia. 0-2) ntawm 90 hnub (67.8% vs 38.5%, p=0.019) piv rau qhov tsis zoo ARTS kos npe.
Kev sib tham
ARTS kos npe yog ib qho yooj yim thiab txhim khu kev qha imaging parameter uas yuav siv tau los txiav txim seb qhov twg ntawm thrombus aspiration thaum kho tshuab thrombectomy. Kev siv ARTS kos npe rau hauv cov txheej txheem ua ke rau kev kho mob thrombectomy tau pom tias yuav txhim kho tus nqi ntawm thawj zaug ua tiav reperfusion thiab cov txiaj ntsig kho mob. ARTS kos npe yuav tsum tau soj ntsuam tas li thaum lub sij hawm kho tshuab thrombectomy kom ua tau zoo ntawm cov txheej txheem.
Xaus
ARTS kos npe yog ib qho kev ntsuas tshiab uas txiav txim siab qhov twg ntawm thrombus aspiration thaum lub tshuab thrombectomy. Kev siv ARTS kos npe rau hauv cov txheej txheem ua ke rau kev kho mob thrombectomy tau pom tias yuav txhim kho tus nqi ntawm thawj zaug ua tiav reperfusion thiab cov txiaj ntsig kho mob. Kev ntsuam xyuas niaj hnub ntawm ARTS kos npe thaum lub sij hawm kho tshuab thrombectomy tuaj yeem txhim kho qhov ua tau zoo ntawm cov txheej txheem thiab txhim kho cov txiaj ntsig ntawm tus neeg mob.