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A Comparison of Stent-Assisted Mechanical Thrombectomy and Conventional Intra-Arterial Thrombolysis for Acute Cerebral Infarction
Journal of Clinical Neurology ; : 91-96, 2013.
Artigo em Inglês | WPRIM | ID: wpr-205178
ABSTRACT
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.

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.

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<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<0.05), and the incidence of symptomatic hemorrhages was lower in SAT patients (3%) than in AMCD patients (18%, p<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<0.05) and 6 months (67% vs. 42%, p<0.05) after discharge.

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.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Artérias / Trombose / Ativador de Plasminogênio Tipo Uroquinase / Stents / Infarto Cerebral / Incidência / Estudos Retrospectivos / Trombectomia / Acidente Vascular Cerebral / Trombólise Mecânica Tipo de estudo: Estudo de incidência / Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: Journal of Clinical Neurology Ano de publicação: 2013 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Artérias / Trombose / Ativador de Plasminogênio Tipo Uroquinase / Stents / Infarto Cerebral / Incidência / Estudos Retrospectivos / Trombectomia / Acidente Vascular Cerebral / Trombólise Mecânica Tipo de estudo: Estudo de incidência / Estudo observacional / Estudo prognóstico Limite: Humanos Idioma: Inglês Revista: Journal of Clinical Neurology Ano de publicação: 2013 Tipo de documento: Artigo