KINH NGHIỆM BƯỚC ĐẦU TRONG ĐIỀU TRỊ ĐỘT QUỴ THIẾU MÁU NÃO CẤP DO TẮC ĐỘNG MẠCH NÃO LỚN BẰNG KỸ THUẬT SOLUMBRA TẠI BỆNH VIỆN CHỢ RẪY

SUMMARY

Background: Mechanical thrombectomy is considered the firstline treatment method for acute ischemic stroke (AIS) due to large vessel occlusion (LVO). Two current main techniques include stent retriever and direct aspiration. Recently, endovascular treatment for AIS has reached a great progression, in which the Solumbra technique, a combination of stent retriever and direct aspiration techniques, has been introduced to achieve high rate of recanalization, to minimize the occurrence of distal embolization and to improve clinical outcomes. We reported initial experience utilizing Solumbra technique at Cho Ray Hospital.

Materials and Methods: Case series report of patients with acute ischemic stroke treated by Solumbra technique at Choray Hospital, from 01/2019 to 01/2021. Clinical, angiographic and outcome features were collected and evaluated.

Results: There were 23 cases treated by Solumbra technique: the mean age was 72 years old, mean NIHSS at admission was 19, good recanalization rate of TICI 2b-3 was achieved in 18/23 (78.3%), functional independence outcomes (90-day mRS 0-2) was 10/23 (43.5%) patients. The embolization to new territories (ENT) was 2/23 (8.7%), the rate of symptomatic intracranial hemorrhage (sICH) was 4/23 (17.4%) and mortality rate was 3/23 (13%) patients during follow-up. The average time from arterial puncture to recanalization was 37.3 minutes.

Conclusion: Mechanical thrombectomy using Solumbra technique appeared to be a fast, safe and effective method with high recanalization rate and good clinical outcomes. Solumbra would be a promising technique to reduce thrombus fragmentation and distal embolization.

Key words: Acute ischemic stroke, large vessel occlusion, endovascular treatment, Solumbra technique.