中国卒中杂志2018，Vol.13Issue(4)：350-363,14.DOI:10.3969/j.issn.1673-5765.2018.04.011
可回收支架尺寸对于急性前循环大血管闭塞治疗效果的影响
Effect of Retrievable Stent Size on Treatment of Acute Anterior Circulation Large Vessel Occlusion
摘要
Abstract
Objective In clinical practice, stent diameter was one of the variable properties which was an important factor for endovascular treatment. A consensus guideline for stent retriever size selection was yet to be established. The aim of this study was to investigate the effects of different diameter Solitaire retrievers on outcomes. Methods Of 628 patients enrolled from the Endovascular Treatment for Acute Anterior Circulation Ischemic Stroke Registry study's database, 256 were treated with the Solitaire 6 mm device and 372 were treated with the 4 mm device. Patients treated with the two sizes of stent were matched by using propensity score analysis. The successful outcome was reperfusion as measured by the modified treatment in cerebral infarction (mTICI) grading immediately post procedure and the dichotomized modified Rankin Scale (mRS) score at 90 days. Symptomatic intracerebral hemorrhage and in hospital mortality were also recorded. Results After propensity score analysis, outcomes of the 6 mm group and 4 mm group were compared and there were no statistical difference in efficacy and safety. In addition, in patients with atherosclerotic-related occlusion, a higher reperfusion rate (P=0.021) was observed in the Solitaire 4 group, as well as a shorter time interval (P=0.002) and fewer passes (P=0.025). Independent predictors of successful reperfusion in patients with atherosclerotic disease on logistic analysis were small stent [odds ratio (OR) 3.217, 95% confidence interval (CI) 1.129-9.162, P=0.029] and propensity score acting as covariate(OR 52.84,95% CI 3.468-805.018,P=0.004). Conclusion The study found no evidence for a differential effect of intra-arterial therapy with regard to the size of Solitaire retrievers. In patients with atheroscleroticlarge vessel occlusion, favorable reperfusion was associated with deployment of a small stent.关键词
急性缺血性卒中/可回收支架/血管开通/取栓Key words
Acutischemic stroke/Stent retriever/Reperfusion/Thrombectomy引用本文复制引用
杨东,肖国栋,熊云云,徐格林,刘新峰,郝永岗,资文杰,王怀明,郑德泉,李华,涂明义,万跃,金平..可回收支架尺寸对于急性前循环大血管闭塞治疗效果的影响[J].中国卒中杂志,2018,13(4):350-363,14.基金项目
国家重点研发计划课题(2017YFC1307901)国家自然科学基金(81530038,81671170,81501193)博士后基金(2015M572815) （2017YFC1307901）
