Stroke yog ib qho mob hnyav uas yuav tsum tau kho tam sim ntawd thiab ua tau zoo. Ib qho kev kho mob zoo tshaj plaws rau kev mob stroke ischemic yog mechanical thrombectomy. Mechanical thrombectomy yog ib txoj hauv kev uas siv cov khoom siv catheter los tshem cov ntshav los ntawm cov hlab ntsha ntawm lub hlwb. Cov txheej txheem no txhim kho cov ntshav khiav thiab txo cov kev pheej hmoo ntawm lub hlwb puas.
Middle cerebral artery (MCA) M2 occlusion yog ib qho ntawm feem ntau hom mob stroke ischemic stroke. Cov kev kho mob rau MCA M2 occlusion suav nrog kev siv cov stent retrievers lossis aspiration catheters. Ob qho khoom siv tau pom tias muaj txiaj ntsig zoo hauv kev kho tus mob no, tab sis tseem muaj kev sib cav txog cov cuab yeej twg muab cov txiaj ntsig zoo dua.
Hauv tsab xov xwm no, peb yuav tham txog qhov ua tau zoo ntawm kev siv tshuab thrombectomy siv lub tshuab nqus tsev vacuum piv nrog stent retriever ib leeg rau MCA M2 occlusion. Peb yuav tshuaj xyuas cov pov thawj muaj thiab tshawb xyuas qhov zoo thiab qhov tsis zoo ntawm txhua lub cuab yeej.
Aspiration Catheter
Aspiration catheters yog ib yam ntawm cov cuab yeej siv tshuab thrombectomy uas ua haujlwm los ntawm kev nqus cov ntshav mus rau hauv lub catheter uas siv qhov nqus. Lub catheter yog muab tso rau hauv cov hlab ntsha los ntawm ib tug me me incision nyob rau hauv puab tais. Thaum lub catheter nyob rau hauv qhov chaw, tus kws kho mob siv suction los tshem cov hlab ntsha.
Qhov zoo ntawm Aspiration Catheter
Lub ntsiab kom zoo dua ntawm ib tug aspiration catheter yog hais tias nws yog ib tug yooj yim ntaus ntawv uas yuav siv tau sai thiab yooj yim. Nws yuav tsum muaj kev txawj ntse tsawg heev los siv, thiab cov txheej txheem tuaj yeem ua tiav hauv lub sijhawm luv luv. Qhov no ua rau nws yog qhov kev xaiv zoo tshaj plaws rau cov xwm txheej kub ntxhov.
Tsis tas li ntawd, cov kev tshawb fawb tau pom tias cov tshuaj aspiration catheters muaj txiaj ntsig zoo hauv kev tshem cov hlab ntsha ntawm lub hlwb. Ib txoj kev tshawb fawb luam tawm xyoo 2018 tau pom tias kev siv cov tshuaj aspiration catheter ua rau muaj kev vam meej ntawm revascularization ntau dua piv nrog kev siv stent retriever (86.7% vs. 74.2%).
Disadvantages ntawm Aspiration Catheter
Ib qho ntawm qhov tsis zoo ntawm lub tshuab nqus pa yog tias nws tsis tuaj yeem tshem tawm cov hlab ntsha loj lossis tawv tawv. Qhov no yog vim hais tias cov txheej txheem cia siab rau kev nqus los tshem cov quav. Yog hais tias lub clot loj dhau los yog ruaj khov rau hauv cov hlab ntsha, qhov nqus yuav tsis txaus los tshem tawm.
Stent Retriever
Stent retrievers yog lwm hom kev siv tshuab thrombectomy uas ua haujlwm los ntawm kev ntxiab cov hlab ntsha hauv stent thiab tom qab ntawd tshem tawm cov stent thiab cov hlab ntsha ntawm cov hlab ntsha. Lub stent retriever yog muab tso rau hauv cov hlab ntsha los ntawm ib tug me me incision nyob rau hauv puab tais.
Qhov zoo ntawm Stent Retriever
Ib qho ntawm qhov zoo ntawm stent retriever yog tias nws muaj peev xwm tshem tawm cov hlab ntsha loj lossis tawv tawv. Qhov no yog vim tias lub cuab yeej siv lub stent txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau, nws tuaj yeem tshem tawm cov hlab ntsha. Qhov no ua rau nws yog qhov kev xaiv zoo tshaj plaws rau cov teeb meem nyuaj ntawm MCA M2 occlusion.
Tsis tas li ntawd, cov kev tshawb fawb tau pom tias stent retrievers muaj txiaj ntsig zoo hauv kev kho MCA M2 occlusion. Ib txoj kev tshawb fawb luam tawm xyoo 2015 pom tias kev siv cov stent retriever ua rau muaj kev vam meej revascularization ntau dua piv nrog kev tswj hwm kev kho mob ib leeg (71% vs. 40%).
Disadvantages ntawm Stent Retriever
Ib qho ntawm qhov tsis zoo ntawm stent retriever yog tias nws yog cov cuab yeej siv ntau dua uas yuav tsum tau siv ntau yam kev txawj ntse. Cov txheej txheem tuaj yeem siv sijhawm ntev dua kom tiav, thiab muaj kev pheej hmoo siab dua ntawm cov teeb meem xws li lub nkoj perforation lossis kev txiav tawm.
Hauv kev xaus, ob qho tib si aspiration catheters thiab stent retrievers tau zoo hauv kev kho MCA M2 occlusion. Kev xaiv ntawm cov cuab yeej yog nyob ntawm tus kheej cov ntaub ntawv thiab tus kws kho mob cov kev txawj ntse. Aspiration catheters yog ib qho kev xaiv yooj yim thiab siv tau rau cov xwm txheej kub ntxhov, thaum stent retrievers zoo dua rau cov teeb meem nyuaj.
Nws yog ib qho tseem ceeb uas yuav tsum nco ntsoov tias mechanical thrombectomy yog ib txoj hauv kev tshwj xeeb uas yuav tsum tau ua los ntawm tus kws kho mob tshwj xeeb hauv lub chaw tshwj xeeb. Nws tseem ceeb heev uas yuav tau nrhiav kev kho mob tam sim yog tias koj muaj cov tsos mob ntawm tus mob stroke, xws li tsis muaj zog tam sim ntawd, loog, lossis hais lus nyuaj. Kev kho mob thaum ntxov tuaj yeem txhim kho cov txiaj ntsig zoo rau cov neeg mob uas mob stroke ischemic.