The efficacy and safety of TREVO stent in the treatment of acute ischemic stroke caused by brachial artery disease

doi:10.3969/j.issn.1672-6731.2020.08.014

Abstract

Abstract:

Objective To explore the efficacy and safety of TERVO stent in the treatment of acute ischemic stroke caused by brachial artery disease. Methods This retrospective study included 9 patients from March 2017 to September 2019 who suffered with acute ischemic stroke caused by brachial artery disease. Among them 5 cases suffered with middle cerebral artery (MCA) M2 occlusion, 2 cases with MCA M3 occlusion and 2 cases with posterior cerebral artery (PCA) P1 occlusion. All patients underwent thrombectomy by TREVO stent while 5 of them were also treated with intravenous thrombolysis in the Department of Vascular Intervention of Civil Aviation General Hospital. The vascular recanalization rate and postoperative bleeding rate were observed, meanwhile the National Institutes of Health Stroke Scale (NIHSS) was used before and 14 d after thrombectomy to assess the degree of neurological impairment. And the prognosis was assessed by the modified Rankin Scale (mRS) 90 d after the operation. Results Among the 9 patients, 8 cases successfully completed the operation of thrombectomy, with a success rate of 8/9. mTICI grading immediately after thrombectomy, showed that 6 patients had grade level 3, 2 had level 2b and one had level 2a, while the rate of vascular recanalization was 8/9. Intracranial hemorrhage occurred in one case, massive cerebral infarction in one case and the clinical symptoms of the other 7 patients were significantly improved after treatment. NIHSS score at admission of 9 patients was 9.00 (7.50, 11.00) while who scored 4.00 (2.50, 5.50) 14 d after thrombectomy. mRS ≤ 2 in 7 cases and > 2 in 2 cases were followed up in 90 d after thrombectomy, with a good prognosis in 7/9. Conclusions TREVO stent has favorable efficacy and safety in the treatment of acute ischemic stroke caused by brachial artery disease.

Key words: Stroke, Brain ischemia, Thrombectomy, Stents, Cerebral angiography

摘要：

目的探讨TERVO支架取栓术治疗分支动脉病变致急性缺血性卒中的疗效及安全性。方法对2017年3月至2019年9月收治的9例颅内分支动脉病变致急性缺血性卒中患者（大脑中动脉M2段闭塞5例、大脑中动脉M3段闭塞2例、大脑后动脉P1段闭塞2例）诊治经过进行回顾分析，采用改良脑梗死溶栓血流分级（mTICI）评估血流再通情况、美国国立卫生研究院卒中量表（NIHSS）评估神经功能缺损程度、改良Rankin量表（mRS）评价90 d预后。结果 9例患者中8例顺利完成手术，手术成功率8/9。术后即刻mTICI分级3级6例、2b级6例、2a级1例，血管再通率8/9。术后发生患侧脑出血1例、大面积脑梗死1例，其余7例闭塞动脉血流通畅、临床症状明显改善。术后14 d NIHSS评分为4.00（2.50，5.50），低于入院时评分9.00（7.50，11.00）；术后90 d mRS评分≤ 2分7例、> 2分2例，预后良好率7/9。结论 TREVO支架取栓术治疗颅内分支动脉病变致急性缺血性脑卒中安全、有效。

关键词: 卒中, 脑缺血, 血栓切除术, 支架, 脑血管造影术

WU Wei-ping, WANG Ning, ZHANG Yang, YANG Wei-li, YANG Han-qing, HU Jun-gang, WANG Chen-long, HU Qun. The efficacy and safety of TREVO stent in the treatment of acute ischemic stroke caused by brachial artery disease[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2020, 20(8): 733-739.

吴卫平, 王宁, 张杨, 杨伟利, 杨汉卿, 胡俊刚, 王辰龙, 呼群. TREVO支架取栓术治疗分支动脉病变致急性缺血性卒中疗效及安全性研究[J]. 中国现代神经疾病杂志, 2020, 20(8): 733-739.

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