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机械血栓切除术在接受抗血小板/抗凝药治疗的患者中的安全性

Abdelaziz Amllay¹, Andrea Becerril-Gaitan², Adam Hunt¹

¹Department of Neurological Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.

World neurosurgery

|May 31, 2023

概括

机械血栓切除术 (MT) 对接受抗凝或抗血小板治疗的急性缺血性中风患者是安全有效的. 包括再通道化和功能状态在内的结果在不同患者群体中是可比的.

科学领域:

神经学神经学
心脏病学心脏病学
干预性放射学干预性放射学

背景情况:

机械血栓切除术 (MT) 是急性缺血性中风的关键干预措施.
许多接受MT治疗的患者已经接受了抗凝血 (AC) 或抗血小板 (AP) 治疗.
关于MT在这些预先接受治疗的患者的安全性和疗效的数据有限.

研究的目的:

为了评估在AC/AP治疗期间接受MT的急性缺血性中风患者的结果.
为了比较MT的安全性和有效性,在AC/AP治疗的患者与不接受此类治疗的患者之间.
分析功能结果,重新道化率和安全事件.

主要方法:

对646名急性缺血性中风患者的回顾性分析,这些患者在10年内 (2012-2022) 接受了MT治疗.
患者被分为抗凝血 (AC),抗血小板 (AP) 或对照组.
评估的结果包括再通道化 (脑损伤中血栓溶解≥2b),功能性结果 (修改的排名表≤2在3个月),症状性内出血 (sICH) 和死亡率.

主要成果:

在AC,AP和对照组之间,症状性内出血 (sICH) 发生率没有显著差异.
在所有组中,成功的再通道化 (92.7%) 同样在所有组中实现.
虽然AC组的住院死亡率较高,但功能性结果和3个月死亡率在各组之间是可比的.

结论:

机械血栓切除术对于急性缺血性中风患者,先前接受抗凝或抗血小板治疗,是可行的,有效的和安全的.
用AC/AP进行预治疗似乎不会对重化或功能恢复等关键疗效结果产生负面影响.
该研究支持在适当的患者中继续使用MT,无论他们之前的AC/AP状态如何.

关键词:

急性缺血性中风是一次急性缺血性中风.抗凝剂是一种抗凝剂.抗血小板药物是一种抗血小板药.机械血栓切除术是一种机械血栓切除术.重新血管化的治疗方法有症状的内出血.血栓溶解是一种血栓溶解.

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