Comparison of clinical outcomes in patients with. acute ischemic strokes treated with mechanical thrombectomy using either Solumbra or ADAPT techniques

被引：149

作者：

Almandoz, Josser E. Delgado ^{[1
]}

Kayan, Yasha ^{[1
]}

Young, Mark L. ^{[2
]}

Fease, Jennifer L. ^{[1
]}

Scholz, Jill M. ^{[1
]}

Milner, Anna M. ^{[1
]}

Hehr, Timothy H. ^{[2
]}

Roohani, Pezhman ^{[2
]}

Mulder, Maximilian ^{[3
]}

Tarrel, Ronald M. ^{[2
]}

机构：

[1] Abbott NW Hosp, Neurosci Inst, Div Neurointervent Radiol, 800 E 28th St, Minneapolis, MN 55407 USA

[2] Abbott NW Hosp, Neurosci Inst, Div Vasc Neurol, Minneapolis, MN USA

[3] Abbott NW Hosp, Neurosci Inst, Div Crit Care Med, Minneapolis, MN USA

来源：

JOURNAL OF NEUROINTERVENTIONAL SURGERY | 2016年 / 8卷 / 11期

关键词：

1ST PASS TECHNIQUE; ENDOVASCULAR TREATMENT; RANDOMIZED-TRIAL; REVASCULARIZATION; EXPERIENCE; RETRIEVER; OCCLUSION; DEVICES; TREVO; COST;

D O I：

10.1136/neurintsurg-2015-012122

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

Purpose To compare rates of symptomatic intracranial hemorrhage (SICH) and good clinical outcome at 90 days in patients with ischemic strokes from anterior circulation emergent large vessel occlusions (ELVO) treated with mechanical thrombectomy using either Solumbra or A Direct Aspiration first-Pass Thrombectomy (ADAPT) techniques. Methods We compared clinical characteristics, procedural variables, and clinical outcomes in patients with anterior circulation ELVOs treated with mechanical thrombectomy using either a Solumbra or ADAPT technique at our institution over a 38-month period. SICH was defined using the SITS-MOST criteria. A good clinical outcome was defined as a modified Rankin Scale score of 0-2 at 90 days. Results One hundred patients were included, 55 in the Solumbra group and 45 in the ADAPT group. Patients in the ADAPT group had higher National Institutes of Health Stroke Scale (NIHSS) (19.2 vs 16.8, p=0.02) and a higher proportion of internal carotid artery terminus thrombi (42.2% vs 20%, p=0.03) than patients in the Solumbra group. Patients in the ADAPT group had a trend toward a lower rate of SICH than patients in the Solumbra group (2.2% vs 12.7%, p=0.07). Patients in the ADAPT group had a significantly higher rate of good clinical outcome at 90 days than patients in the Solumbra group (55.6% vs 30.9%, p=0.015). Use of the ADAPT technique (OR 6 (95% CI 1.0 to 31.2), p=0.049) was an independent predictor of a good clinical outcome at 90 days in our cohort. Conclusions In our cohort, the ADAPT technique was associated with significantly higher good clinical outcomes at 90 days in patients with acute ischemic stroke due to anterior circulation ELVOs treated with mechanical thrombectomy.

引用

页码：1123 / 1128

页数：6

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