ỨNG DỤNG KỸ THUẬT LẤY HUYẾT KHỐI BẰNG DỤNG CỤ CƠ HỌC SOLITAIRE Ở BỆNH NHÂN NHỒI MÁU NÃO CẤP DO TẮC MẠCH MÁU LỚN TẠI BVĐK TỈNH THANH HÓA

Abstract

Objectives: (1) Assess the outcome of mechanical thrombectomy with Solitaire stent for acute ischemic stroke patients. (2) Finding prognostic predictors of clinical outcome at 3 months. Methods: A descriptive study of 35 cases of acute ischemic stroke within 6 hours from the onset, treated by mechanical thrombectomy with Solitaire stent, in the Department of Neurology – Stroke, Thanh Hoa General Hospital from April 2019 to April 2020. Results: Mean age was 64.57± 10.20, male/female ratio was 1/1.06, mean NIHSS score at admission was 13.22 ± 5.38 points, median was 13 points; hypertention was 71.43%, diabetes was 25.71%, atherosclerosis was 54.29%, atrial fibrillation was 34.29%, heart failure was 20%, heart valve disease was 17.14%. The median point of the prognostic scales: ASPECT, HAT, DRAGON, ASTRAL was 7, 1, 5, and 25 points, respectively. MCA hyperdense sign on CT scans accounted for 37.14%, carotid plus M1 MCA occlusion was 28.57%, lone MCA occlusion was 62.86%, basilar occlusion was 8.57%. The rate of atherosclerotic arterial etiology was 51.42%, cardioembolic was 34.29%, undetermined causes was 14.29%. Recanalisation rate of TICI 3, TICI 2b and TICI 2a were 42.86%, 17.14% and 22.0% respectively. Symptomatic cerebral hemorrhage rate was 8.57%, favorable outcome  after 3 months (mRS 0-2) was 34.29%, death rate at 3 months was 14.29%. Conclusion: Mechanical thrombectomy by Solitaire stent for a series of 35 patients with acute ischemic stroke within 6 hours from onset showed that the procedure had successfully done  in terms of revascularization.The rate of symptomatic intracranial hemorrhage was 8.57%. The good outcome (mRS 0-2) at 3 months was 34.29%. Death at 3 months was 14.29%. Further studies are needed to obtain more data in the coming years.