Đánh giá hiệu quả điều trị của phương pháp lấy huyết khối bằng dụng cụ cơ học ở bệnh nhân đột quỵ thiếu máu não cấp do tác nhánh lớn động mạch nội sọ có rung nhĩ

Abstract

Objective: To evaluate the results and complications of mechanical thrombectomy (MT) in acute ischemic stroke (AIS) in patients by large vessel occlusion (LVO) with atrial fibrillation (AF). Subject and method: Clinical intervention, self-controlled studies 121 patients with AIS by LVO with AF, who's had  used MT at 108 Military Central Hospital from 6/2016 to 7/2017. Description of general characteristics, location of cerebral occlusion, interval of time from onset to revascularization, ASPECTS score, outcome after intervention and complications. Result: The average age was 64.7 ± 12.7 years old, 49.6% men. Occlusions were located in the middle cerebral artery M1 (39.7%), internal carotid artery (44.6%) and basilar arteries (10.7%). Mainly ASPECTS score from 6 point were 91.7%. Non-valvular AF was 59.6%.  62% patients who had high risk in predicting stroke (CHA₂DS₂ - VASc score ≥ 2 (male) or ≥ 3 (female)) sustained antithrombotic therapy. Good reperfusion (mTICI = 2b, 3) accounted for 97.5%. The good function recovery (mRS = 0 - 2) after 90 days was 70.3%, mortality were 19.8%. The most common complications were symptomatic intracranial haemorrhage (9.9%), embolization to previously uninvolved territory 22.5% and vessel dissection in 5 patients (2.5%). Conclusion: MT in AIS in patient by LVO with AF at 108 Military Central Hospital had a high rate good reperfusion, improved good neurological function and had complication of symptomatic intracranial hemorrhage (sICH) still within the acceptable range for an emergency intervention procedure.