急性后循环粥样硬化性脑卒中抽吸取栓与支架取栓疗效和安全性比较

Comparison of Efficacy and Safety between Aspiration and Stent Embolectomy in Acute Posterior Circulation Atherosclerotic Strokes

摘要: 目的：比较急性后循环粥样硬化性脑卒中抽吸取栓与支架取栓在疗效及安全性方面的差异。方法：采用回顾性队列研究方法纳入2021年1月至2024年11月因急性后循环粥样硬化性脑卒中在山东第一医科大学第二附属医院接受经皮介入取栓手术治疗的患者105例，其中采用抽吸取栓的患者48例，采用支架取栓的患者57例，收集患者基线资料、既往病史、烟酒暴露史、血管再通情况、穿刺至再通时间、入院NIHSS评分、入院mRS评分、术后90天mRS评分等资料。结果：两组患者入院NIHSS评分、入院mRS评分比较，P > 0.05；抽吸取栓患者术后90天mRS评分低于支架取栓组，P < 0.05；靶血管再通率两组结果比较，P > 0.05，但首次再通率抽吸组高于支架组，P < 0.05；抽吸组穿刺至再通时间短于支架组，P < 0.05。结论：抽吸取栓能在更短的时间内开通靶血管，拥有更高的首次再通率及更短的穿刺至再通时间，且在远期神经功能预后方面优于支架取栓，将抽吸取栓作为急性后循环粥样性脑卒中患者血管内治疗的首选治疗策略可能对患者更有利。

Abstract: Objective: To compare the efficacy and safety of aspiration thrombectomy and stent thrombectomy in acute posterior circulation atherosclerotic stroke. Methods: A retrospective cohort study was conducted in 105 patients with acute posterior circulation atherosclerotic stroke who received percutaneous interventional thrombectomy in the Second Affiliated Hospital of Shandong First Medical University from January 2021 to November 2024, including 48 patients with aspiration thrombectomy and 57 patients with stent thrombectomy. The baseline data, past medical history, exposure history of smoking and drinking, time from puncture to recanalization and other related data were collected, and the related factors of poor prognosis were analyzed by binary Logistic regression. Results: The comparison of NIHSS score and mRS score at admission between the two groups showed P > 0.05. The mRS score at 90 days after embolectomy was lower in the aspiration group than that in the stent group (P < 0.05). The comparison of target vessel recanalization rate between the two groups showed P > 0.05, but the first recanalization rate in the aspiration group was higher than that in the stent group (P < 0.05); The time from puncture to recanalization in the aspiration group was shorter than that in the stent group (P < 0.05). Conclusion: Aspiration thrombectomy can open the target vessel in a shorter time, has a higher first recanalization rate and a shorter time from puncture to recanalization, and is superior to stent thrombectomy in long-term neurological prognosis. Aspiration thrombectomy as the preferred treatment strategy for patients with acute posterior circulation atherosclerotic stroke may be more beneficial.