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2023年度脑血管病规范诊治能力提升培训，国家神经系统疾病质控中心脑血管病质控工作组专家精心撰写21篇脑梗死临床干货，全面提升脑梗死诊疗能力！

Stroke & Vascular Neurology（SVN）最新上线文章“Comparing a novel Catfish flow restoration device and the Solitaire stent retriever for thrombectomy revascularisation in emergent large vessel occlusion stroke: a prospective randomised controlled study”，来自首都医科大学附属北京天坛医院神经病学中心介入神经病学科缪中荣教授团队等。

Catfish取栓支架是一种新近发展的机械取栓装置，用于急性大血管闭塞（emergent large vessel occlusion, ELVO）卒中的快速再通。该试验旨在评估Catfish取栓支架在ELVO卒中的结局方面的效果是否非劣效于Solitaire取栓支架。

研究结果显示，2019年3月3日至2021年6月5日期间，分别有118例和120例患者被随机分配至Catfish组和Solitaire组。Catfish组所有血管内手术后的主要终点（88.5%, 100/113）不劣于Solitaire组（87.7%, 100/114），率差（rate difference, RD）为0.78%（95%CI -7.64至-9.20；p=0.001）。对仅考虑每个方案集的敏感性分析也得到了类似的结果，RD为0.83% （95%CI -7.03至-8.70；p<0.001）。此外，两组患者90天临床结局良好的病例比例（47.8% vs 50.0%，p=0.739）和全因死亡率（17.7% vs 18.8%，p=0.700）相似。

Figure 1. Illustration of the Catfish stent-retriever device. (A) The thinner strut of the proximal-third segment and distal-third segment which was equal to the 0.7-fold diameter of the strut at the middle-third segment, three distal radio-opaque markers. A2: large clot-catching cell. A3: radiopaque platinum wire integration into the stent strut. A4: One Proximal radio-opaque marker. (B) The Catfish (B2) has a larger stent cell compared to the competitive stent (B1). (C) The Catfish have optimal coverage and wall apposition peculiarity in the tortuous anatomical model. (D) Fluoroscopic visibility of the deployed Catfish stent retriever device.

Figure 3. Treatment outcomes. (A) Immediately mTICI grade after first pass thrombectomy; (B) mTICI grade at the end of the procedure, the successful recanalization rate at the end of the precedure in the Catfish group was non-inferior to that in the Solitaire group for per-protocol population analysis (rate difference, 0.83; 95% CI –7.03 to 8.70;). (C) and (D) Modified Rankin Scale at 3 months.

Figure 4. Categorised whisker plots of mean NIHSS scores at admission, at 24 hours, and at 7 days or discharge in both groups.