Impact of Merci device fracture on clinical outcome of acute ischemic stroke after mechanical thrombectomy.
Impact of Merci device fracture on clinical outcome of acute ischemic stroke after mechanical thrombectomy.
复制标题
Merci 装置断裂对机械血栓切除术后急性缺血性卒中临床结果的影响。
DOI：
10.1111/j.1755-5949.2012.00377.x
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发表时间：
2012
影响因子：
5.5
通讯作者：
Vinuela,Fernando
中科院分区：
文献类型：
--
作者：
Shi,Zhong-Song;Duckwiler,GaryR;Loh,Yince;Liebeskind,DavidS;Gonzalez,NestorR;Tateshima,Satoshi;Jahan,Reza;Saver,JeffreyL;Vinuela,Fernando
AimsTo调查与机械血栓切除术治疗的急性缺血性中风患者的Merci设备断裂的频率和预测因素及其对临床outcome.MethodsWe的影响回顾性分析血栓切除术与Merci取栓器治疗的急性缺血性中风患者，并确定设备断裂的存在。评估了器械断裂的预测因素。我们评估了器械断裂对出血和临床结局的影响。ResultsOf 136例血栓切除术治疗的患者中，6例（4.4%）发生了术中Merci器械断裂。颈内动脉闭塞与器械断裂相关。在4名患者中成功圈套了断裂的X和L系列Merci取栓器。器械断裂患者的成功血运重建率与未断裂患者相似。在器械断裂的患者中，未发现脑实质血肿，而分别在3例和2例患者中发现出血性梗死和蛛网膜下腔出血。器械断裂的患者出院时倾向于更依赖（改良兰金量表≥ 3），但院内死亡率相似。这种并发症可能不会增加脑实质血肿的风险，但往往与不良结局相关。
AimsTo investigate the frequency and predictors of Merci device fracture in patients with acute ischemic stroke treated with mechanical thrombectomy and its impact on clinical outcome.MethodsWe retrospectively analyzed patients with acute ischemic stroke treated by thrombectomy with the Merci Retriever and identified the presence of device fracture. The predictors of device fracture were assessed. We evaluated the impact of device fracture on hemorrhage and clinical outcome.ResultsOf 136 patients treated by thrombectomy, 6 (4.4%) experienced intraprocedural Merci device fracture. Internal carotid artery occlusion was associated with device fracture. The fractured X and L series Merci Retrievers were successfully ensnared in four patients. Patients with fractured devices had similar rates of successful revascularization with those without. In patients with fractured devices, no parenchymal hematomas were found, while hemorrhagic infarction and subarachnoid hemorrhage were found in three and two patients, respectively. Patients with fractured devices tended to be more dependent (modified Rankin Scale ≥ 3) at discharge, but had similar rates of in‐hospital mortality.ConclusionsMerci device fracture is relatively infrequent in patients with acute ischemic stroke treated with thrombectomy. This complication may not increase the risk of parenchymal hematoma but tends to be associated with poor outcome.