Tam sim no muaj ob txoj kev kho mob thrombectomy tseem ceeb rau kev kho mob hlab ntsha tawg. Qhov thib ib yog stent retrieval. Cov txheej txheem thib ob siv cov txheej txheem FAST lossis ADAPT nrog txoj kab uas hla loj lumen aspiration catheter rau ncaj qha thrombus aspiration. Tsis tas li ntawd, qee qhov kev tshawb fawb tau txhim kho tus nqi recanalization los ntawm kev sib xyaw ua ke ntawm ob txoj hauv kev tseem ceeb, uas yog, kev siv cov stent retrieval thiab ncaj qha aspiration.
Txawm hais tias kev nce qib hauv cov cuab yeej siv thiab thev naus laus zis, ib zaug thrombectomy tsis tuaj yeem lav 100 feem pua kev ua tiav tiav, tsis hais seb stent retrieval lossis thrombus aspiration yog siv los ua cov txheej txheem tseem ceeb. Txawm tias nyob rau hauv 2015 tsis ntev los no randomized tswj kev sim (feem ntau raws li stent retriever) cov lus xaus yog zoo ib yam. Hauv Dutch multi-center randomized soj ntsuam sim ntawm endovascular therapy rau mob ischemic stroke, tus nqi recanalization yog 59 feem pua. Hauv kev kho mob intra-arterial, tus nqi ntawm recanalization yog 82 feem pua. Hauv kev kho mob hauv cov hlab ntsha prolongs lub sij hawm ntawm thrombolysis nyob rau hauv thaum muaj xwm ceev neurological deficits, thiab tus nqi ntawm recanalization yog 86 feem pua. Tus nqi ntawm recanalization nyob rau hauv proximal me me infarction ua ntej endovascular txoj kev kho, hais txog qhov txo qis ntawm CT rau lub sij hawm recanalization (79 feem pua ntawm cov khoom siv yog stent retrievers), thiab tus nqi recanalization yog 72 feem pua. Tus nqi ntawm recanalization nyob rau hauv SWIFT PRIME yog 88 feem pua, thiab revascularization nrog ib tug thrombectomy ntaus ntawv yog 66 feem pua piv nrog kev pom zoo kev kho mob ntawm anterior ncig stroke nyob rau hauv 8 teev. Txawm hais tias cov ntsiab lus ntawm kev cuam tshuam cov tswv yim sib txawv me ntsis los ntawm kev sim mus sim, cov kev tshawb fawb no qhia tias cov kws kho mob yuav tsum tau npaj cov tswv yim khaws cia rau cov neeg mob uas tsis ua tiav nrog ib lub tswv yim. Cov kev tshawb pom zoo sib xws tau tshaj tawm txog kev siv thrombus aspiration raws li cov txheej txheem tseem ceeb. Kev ua tiav cov txiaj ntsig rov qab tau zoo, txhais tau tias yog TICI 2b lossis 3, yog 82 feem pua hauv thawj zaug FAST sim. Recanalization tus nqi yog 65 feem pua hauv lwm qhov kev sim FAST rau qhov mob ICA occlusion, thiab 75 feem pua hauv ADAPT sim. Yog tias txoj kab uas hla loj lumen catheter aspiration yog siv los ua thawj kab txheej txheem, thiab ntau qhov kev hla tsis tuaj yeem rov ua dua, lossis qhov loj hauv lumen aspiration catheter tsis tuaj yeem mus rau qhov occlusion vim lub nkoj tortuosity, tus kws kho mob yuav tsum tau siv stent retrieval los yog lwm yam. txoj kev kho mob.
Raws li cov kev tshawb fawb saum toj no, muaj qee qhov kev tshawb fawb los ua kom tus nqi recanalization los ntawm kev siv ob qho tib si stenting thiab aspiration. Thawj yog hu ua lub tswv yim hloov, hloov ntawm FAST mus rau stent retrieval, thiab qhov thib ob yog cov txheej txheem Solumbra, uas siv ob qho tib si tib lub sijhawm. Thaum ob txoj hauv kev sib koom ua ke hauv lub tswv yim ntawm kev siv ob lub thev naus laus zis ua ke, cov ntsiab lus sib txawv heev. Qee qhov kev sib txawv no nyob hauv txoj cai tswjfwm thiab kev cai lij choj nyob rau hauv lub zog hauv cheeb tsam. Piv txwv li, kev hloov pauv lub tswv yim rau kev kho tshuab thrombectomy tiag tiag los ntawm cov kev txwv ntawm Kauslim kev pov hwm kev noj qab haus huv. Tshwj xeeb, Kaus Lim Qab Teb tsoomfwv txhawb nqa kev pov hwm kev noj qab haus huv rau pej xeem tau them txog 90 feem pua ntawm tus nqi ntawm thawj thrombectomy ntaus ntawv, txawm hais tias nws yog stent retriever lossis ib txoj kab uas hla loj aspiration catheter rau tus neeg mob stroke ua tshuab thrombectomy. Qhov no txhais tau hais tias yog tus neeg teb xov tooj siv txoj kev thib ob rau kev kho mob, tus neeg mob tsev neeg yuav them tus nqi tag nrho ntawm txoj kev thib ob. Ntawm qhov tod tes, nyob rau qee lub tebchaws, xws li Tebchaws Meskas, tus neeg teb xov tooj tuaj yeem txiav txim siab seb puas yuav siv lub thrombectomy stent thiab ib txoj kab uas hla loj aspiration catheter nyob rau tib lub sijhawm los txhim kho kev ua haujlwm zoo thaum lub sijhawm ua haujlwm. Kev sib xyaw ua ke feem ntau yog kev siv lub thrombectomy stent thiab aspiration catheter, yog li nws tau hu ua "Solumbra technique".