Akut inme hastalarında Sofia katater ile direkt aspirasyon yönteminin sonuçları

Yıl 2020, Cilt: 45 Sayı: 2, 455 - 460, 30.06.2020

Yılmaz Önal Murat Velioğlu Uğur Demir Volga Ercan Ezgi Yakupoğlu Hakkı M. Karakaş

https://doi.org/10.17826/cumj.688708

Öz

Amaç: Bu çalışmada akut iskemik inme hastalarında 6F Sofia katater ile direk aspirasyon yönteminin (ADAPT) etkinliği ve güvenirliğinin gösterilmesi amaçlanmıştır.
Gereç ve Yöntem: Çalışmamıza Mart 2017-Temmuz 2019 tarihleri arasında, akut inme nedeniyle başvuran ve ön sistem büyük damar okluzyonu saptanarak Sofia katater ile ADAPT uygulanan 117 hasta dahil edildi. Tandem okluzyonlar ve arka sistem inmeler çalışmaya dahil edilmedi. İşlem sonrası başarılı açıklık oranları, post-operatif kanama komplikasyonları ve hastaların 90. gün modified Rankin Scale (mRS) skorları değerlendirildi.
Bulgular: Hastaların 86’sında (%73.5) okluzyon orta serebral arterde (MCA), 31’inde (%16.5) internal karotis arter (ICA) tepe kısımdaydı. Açıklık oranları Thrombolysis in Cerebral Infarction (Tici) skorlamasına göre değerlendirildi. Başarılı rekanalizasyon (Tici ≥ 2b) %83.7, 90. gün iyi klinik sonuç (mRS 0-2) %43.5 olarak bulundu. Semptomatik kanama ise hastaların %7.69’unda görüldü. ADAPT ile başarılı açıklık sağlanamayan ve ek olarak stentretriever kullanılan 32 hastada başarılı açıklık %59.3 idi. %15.3 hastada mortalite izlendi.
Sonuç: Sofia, hastaların birçoğunda okluzyon seviyesine kadar ilerleyebilmesi, kost-efektif olması ve ADAPT ile yüksek başarılı açıklık oranları sağlaması ile endovasküler inme tedavisinde etkili ve güvenli bir şekilde kullanılabilir

Anahtar Kelimeler

Akut inme, Trombektomi, Sofia

Teşekkür

İstatiksel analizler için Doç. Dr. Arzu Velioğlu'na teşekkür ediyoruz.

Outcomes of direct aspiration method with Sofia catheter in acute stroke patients

Öz

Purpose: The aim of this study was to demonstrate the efficacy and safety of direct aspiration method (ADAPT) with 6F Sofia catheter in patients with acute ischemic stroke.
Materials and Methods: Between March 2017 and July 2019, 117 patients who applied for acute stroke and had anterior system large vessel occlusion underwent ADAPT with Sofia catheter were included in our study. Tandem occlusions and posterior system occlusions were not included in the study. Successful recanalization rates, post-operative bleeding complications and 90th day mRS scores of the patients were evaluated.
Results: Occlusion was in the middle cerebral artery (MCA) in 86 (73.5%) of the patients, and internal carotid artery (ICA) bifurcation in 31 (16.5%). Patency rates were evaluated according to Thrombolysis Cerebral Infarction (Tici) score. Successful recanalization (Tici ≥ 2b) was found as 83.7%, and 90th day good clinical outcome (mRS 0-2) was 43.5%. Symptomatic bleeding was observed in 7.69% of the patients. Successful patency was 59.3% in 32 patients who could not be successfully recanalized with ADAPT and additionally used stentretriever. Mortality was observed in 15.3% of the patients.
Conclusion: Sofia can be used effectively and safely in the endovascular treatment of acute stroke with its ability to progress up to the level of occlusion in many patients, with its cost-effectiveness and high successful patency rates with ADAPT.

Anahtar Kelimeler

Acute stroke, thrombectomy, Sofia

Kaynakça

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