Application of stent retriever thrombectomy in acute refractory occlusion of major intracranial arteries
10.3760/cma.j.cn431274-20240921-01449
- VernacularTitle:支架再取栓在急性难治性颅内大动脉主干部闭塞中的应用
- Author:
Huan ZHANG
1
;
Jianfeng LI
1
;
Chen FANG
1
Author Information
1. 湖南省人民医院（湖南师范大学附属第一医院）神经内科，长沙 410005
- Publication Type:Journal Article
- Keywords:
Stents;
Balloon;
Embolectomy;
Intracranial arterial diseases;
Intracranial embolism
- From:
Journal of Chinese Physician
2025;27(10):1483-1488
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy and safety of stent retriever thrombectomy after balloon angioplasty in the treatment of acute refractory occlusion of major intracranial arteries.Methods:A retrospective analysis was performed on the clinical data of 11 patients with acute refractory occlusion of major intracranial arteries who underwent stent retriever thrombectomy after balloon angioplasty in the Hunan Provincial People′s Hospital from April 2019 to June 2023. Data collected included patients′ age, gender, occlusion site, anesthesia method, surgical approach, reasons for stent retriever thrombectomy, materials used in surgery, time from symptom onset to vascular recanalization, time from puncture to vascular recanalization, National Institutes of Health Stroke Scale (NIHSS) scores on admission and 7 days after surgery, history of intravenous thrombolysis, extended thrombolysis in cerebral infarction (eTICI) grade after thrombectomy, surgery-related complications, postoperative vascular patency, and modified Rankin Scale (mRS) score at 90 days after surgery. The primary outcome was the mRS score at the 90-day follow-up, and the secondary outcomes included intraoperative vascular recanalization, postoperative vascular reocclusion, and perioperative complications.Results:All 11 patients achieved effective vascular recanalization intraoperatively, including 9 cases of eTICI grade 3 and 2 cases of eTICI grade 2c. Intraoperatively, 2 cases developed arterial dissection; postoperatively, 2 cases had symptomatic hemorrhage, and 1 case had contralateral cerebral infarction. Follow-up head computed tomography angiography (CTA) or digital subtraction angiography (DSA) in 10 patients showed patent blood vessels. At 90 days, 10 patients had a favorable prognosis (based on mRS score) and 1 had an unfavorable prognosis.Conclusions:Stent retriever thrombectomy after balloon angioplasty for acute refractory occlusion of major intracranial arteries has a high vascular recanalization rate, low postoperative reocclusion rate, good safety, and favorable clinical efficacy.
