Analysis of the efficacy of double-stent combined with intermediate catheter aspiration technology in the rescue treatment of acute cardiogenic intracranial large vessel occlusion
Objective To investigate the efficacy and safety of double-stent combined with intermediate catheter aspiration technique as a rescue treatment in the acute cardiogenic intracranial large vessel occlusion.Methods The clinical data of 20 patients with acute cardiogenic intracranial large vessel occlusion who received rescue treatment with double stents from January 2019 to June 2023 in the Department of Neurointervention,Luoyang Central Hospital Affiliated to Zhengzhou University were retrospectively analyzed.Conventional thrombectomy and rescue measures failed more than 3 times in all patients before the application of the two-stent combined with intermediate catheter aspiration technique remedy.The recanalization of occluded blood vessels was evaluated immediately after surgery.Modified Thrombolysis in Cerebral Infarction(mTICI)grade ≥2b indicated good recanalization.The modified Rankin Scale(mRS)was used to evaluate neurological deficits 90 days after surgery,with ≤2 points indicating good outcome and 3-6 indicating poor outcome.Results Among the 20 patients,17 patients had good vessel recanalization(mTICI ≥ grade 2b),1 patient had partial vessel recanalization(mTICI grade 2a),and 2 patients had failed vessel recanalization.Thrombus escape occurred in 1 case,vasospasm in 10 cases,subarachnoid hemorrhage in 3 cases,and symptomatic cerebral hemorrhage in 3 cases.After 90 days of follow-up,6 cases had a good outcome;14 cases had a poor outcome,including 10 cases with mRS of 3 to 5 points and 4 cases with mRS of 6 points(death).Conclusion As a rescue treatment for acute cardiogenic intracranial large blood vessel occlusion,double stents combined with intermediate catheter aspiration can recanalize most of the blood vessels,and most of the surgery-related complications can be recovered after treatment.
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