机构:[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China神经内科首都医科大学宣武医院[2]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China神经外科首都医科大学宣武医院[3]Department of Neurointerventional Surgery, Hartford Hospital, Hartford, CT, USA[4]Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA[5]Department of Emergency, Xuanwu Hospital, Capital Medical University, Beijing, China急诊科首都医科大学宣武医院[6]Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China血管外科首都医科大学宣武医院[7]Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China放射科首都医科大学宣武医院[8]China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China中美神经科学研究所首都医科大学宣武医院
This is a prospective non-randomized cohort study of 113 consecutive patients to investigate the safety and efficacy of a short-duration intraarterial selective cooling infusion (IA-SCI) targeted into an ischemic territory combined with mechanical thrombectomy (MT) in patients with large vessel occlusion-induced acute ischemic stroke (AIS); 45/113 patients underwent IA-SCI with 350 ml 0.9% saline at 4celcius for 15 min at the discretion of the interventionalist. Key parameters such as vital signs and key laboratory values, symptomatic and any intracranial hemorrhage, coagulation abnormalities, pneumonia, urinary tract infections and mortality were not significantly different between the two groups. Final infarct volume (FIV) was assessed on noncontrast CT performed at three to seven days. After an adjusted regression analysis, the between-group difference in FIV (19.1 ml; 95% confidence interval (CI) 3.2 to 25.2; P = 0.038) significantly favored the IA-SCI group. At 90 days, no differences were found in the proportion of patients who achieved functional independence (mRS 0-2) (51.1% versus. 41.2%, adjusted odd ratio (aOR) 1.9, 95% CI 0.8-2.6, P = 0.192). Combining short-duration IA-SCI with MT was safe. There was a smaller FIV and trend towards clinical benefit that will need to be further evaluated in randomized control trials.
基金:
This work was supported by National Natural Science
Foundation of China (81325007, 81701287); Chang Jiang
Scholars Program (No. T2014251)
第一作者机构:[1]Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
通讯作者:
通讯机构:[*1]Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 of Changchun Street, Beijing, China.
推荐引用方式(GB/T 7714):
Chuanjie Wu,Wenbo Zhao,Hong An,et al.Safety, feasibility, and potential efficacy of intraarterial selective cooling infusion for stroke patients treated with mechanical thrombectomy[J].JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM.2018,38(12):2251-2260.doi:10.1177/0271678X18790139.
APA:
Chuanjie Wu,Wenbo Zhao,Hong An,Longfei Wu,Jian Chen...&Xunming Ji.(2018).Safety, feasibility, and potential efficacy of intraarterial selective cooling infusion for stroke patients treated with mechanical thrombectomy.JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM,38,(12)
MLA:
Chuanjie Wu,et al."Safety, feasibility, and potential efficacy of intraarterial selective cooling infusion for stroke patients treated with mechanical thrombectomy".JOURNAL OF CEREBRAL BLOOD FLOW AND METABOLISM 38..12(2018):2251-2260