Đánh giá kết quả nong đặt stent nội sọ sau thất bại lấy huyết khối điều trị đột quỵ tắc mạch máu lớn=Evaluation of the result of rescue intracranial stent after failed mechanical thrombectomy for acute ischemic stroke

0 Người đánh giá. Xếp hạng trung bình 0

Tác giả: Huy Thắng Nguyễn, Minh Đức Nguyễn, Anh Tuấn Phạm

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.172-188

Bộ sưu tập: Metadata

ID: 242209

Thêm vào giỏ

Đánh giá kết quả nong đặt stent nội sọ cấp cứu trong điều trị bệnh lý đột quỵ tắc mạch máu lớn (tỉ lệ tái thông, tỉ lệ chuyển dạng xuất huyết, mRS xuất viện, mRS sau 3 tháng. 2. Xác định các yếu tố liên quan đến kết cục lâm sàng sau nong đặt stent nội sọ cấp cứu trong bệnh lý đột quỵ tắc mạch máu lớn. Đối tượng và phương pháp: nghiên cứu tiến cứu mô tả loạt ca. Tất cả bệnh nhân được chẩn đoán đột quỵ nhồi máu não cấp tắc mạch máu lớn, thất bại với kỹ thuật lấy huyết khối, có hẹp động mạch nội sọ tại Bệnh viện 115 trong giai đoạn từ 07/2022 đến 07/2023. Kết quả: tỷ lệ đối tượng nghiên cứu đạt phục hồi thần kinh tốt tại thời điểm sau ra viện 90 ngày với thang điểm Rankin sửa đổi từ 0-2 điểm là 57,1%. Tỉ lệ tái thông mạch máu thành công theo thang điểm TICI 2b-3 là 100%. Chảy máu não (CMN) chuyển dạng chiếm 28,6%, trong đó CMN có triệu chứng: 8,6%. Tỉ lệ tử vong tại thời điểm 90 ngày: 14,3%. Thang điểm NIHSS tăng 1 điểm, khả năng kết cục lâm sàng có lợi (mRS 0-2 điểm) giảm 11%. NIHSS  13 điểm tiên đoán lâm sàng bất lợi với độ chính xác 68,6%. không tìm thấy các yếu tố liên quan đến kết cục lâm sàng tử vong và CMN có triệu chứng. Kết luận: Phương pháp can thiệp đặt stent nội sọ sau thất bại lấy huyết khối cơ học điều trị đột quỵ nhồi máu não (NMN) tắc mạch lớn có hẹp động mạch nội sọ có tỉ lệ thành công cao, tỉ lệ tử vong và tai biến thấp.Evaluate the results of rescue intracranial stent after Failed mechanical thrombectomy for acute ischemic stroke (recanalization rate, brain hemorrhagic transformation rate, 90-day mRS, mRS). Identify factors related to clinical outcomes after of rescue intracranial stent. Method: prospective descriptive study of case series. All patients were diagnosed with acute ischemic stroke, large vessel occlusion, failure of thrombectomy, and intracranial artery stenosis at Hospital 115 in the period from July 2022 to July 2023. Results: the rate of good neurological recovery at 90 day mRS after discharge with a modified Rankin scale of 0-2 points is 57.1%. The successful revascularization rate of TICI 2b-3 is 100%. Rate of cerebral hemorrhage transformation is 28.6%, symptomatic cerebral hemorrhage is 8.6%. The mortality rate at 90 days is 14.3%. An increase of 1 point in the NIHSS scale reduces a favorable clinical outcome (mRS 0-2 points) 11%. NIHSS  13 points predict adverse clinical outcomes with specificity 68.6%. Factors related to death and symptomatic cerebral hemorrhage could not be found. Conclusion: Rescue intracranial stents after failed mechanical thrombectomy has a high success rate, low mortality and low complication rates.

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