A Comparison of Stent-Assisted Mechanical Thrombectomy and Conventional Intra-Arterial Thrombolysis for Acute Cerebral Infarction

作者：Jeong Hye Seon; Song Hee Jung; Kim Seong bo; Lee Juyoun; Kang Chang Woo; Koh Hyeon Song; Shin Ji Eun; Lee Suk Hoon; Kwon Hyun Jo; Kim Jei^*

来源：Journal of Clinical Neurology, 2013, 9(2): 91-96.

DOI：10.3988/jcn.2013.9.2.91

• acute stroke
• mechanical thrombolysis
• stent-assisted thrombectomy

Background and Purpose We evaluated whether stent-assisted thrombectomy (SAT) is safer or more clinically beneficial than aggressive mechanical clot disruption (AMCD) for patients with acute intracranial artery occlusion. %26lt;br%26gt;Methods We retrospectively analyzed the clinical data of 72 patients (33 with SAT and 39 with AMCD) who underwent intra-arterial thrombolysis for acute intracranial artery occlusions. Procedure parameters, clinical outcomes, and incidence of complications were compared between the SAT and AMCD groups. %26lt;br%26gt;Results The time interval to recanalization was shorter in SAT patients (69.2 +/- 39.6 minutes, mean standard deviation) than in AMCD patients (94.4 +/- 48.0 minutes, p%26lt;0.05). Recanalization was achieved in more SAT patients (91%) than AMCD patients (80%), but with no statistically significance. Urokinase was used less frequently in SAT patients (21%) than in AMCD patients (92%, p%26lt;0.05), and the incidence of symptomatic hemorrhages was lower in SAT patients (3%) than in AMCD patients (18%, p%26lt;0.05). Device-related complications in SAT patients comprised two cases of stent fracture and one case of distal migration of a captured thrombus. The proportion of patients with good outcomes, defined as scores from 0 to 3 on the modified Rankin Scale, was similar in the two groups at discharge (SAT, 46%; AMCD, 39%), but significantly higher in the SAT group than in the AMCD group at 3 months (64% vs. 40%, p%26lt;0.05) and 6 months (67% vs. 42%, p%26lt;0.05) after discharge. %26lt;br%26gt;Conclusions The outcomes and clinical parameters were better for SAT during thrombolytic procedures for acute intracranial artery occlusions than for AMCD for up to 6 months. However, some device-related complications occurred during stent interventions. J Clin Neurol 2013;9:91-96

• 出版日期2013-4