大型缺血性中风的机械血栓切除术:系统性审查和元分析
Qi Li1, Mohamad Abdalkader1, James E Siegler1
1From the Department of Neurology (Q.L., Q.H., Y.D., Z.Q.), the 903rd Hospital of The Chinese People's Liberation Army, Hangzhou, China; Department of Radiology (M.A.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA; Cooper Neurological Institute (J.E.S.), Cooper University Hospital, Camden, NJ; Rhode Island Hospital (S.Y.), Brown University, Providence; University Hospitals Cleveland Medical Center (A.S., D.P.), Case Western Reserve University, OH; Medicine and Neurology (B.C.V.C.), Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, VIC, Australia; Texas Stroke Institute (A.J.Y.), Dallas Fort Worth; Neuroscience and Stroke Program (O.O.Z.), Bon Secours Mercy Health St Vincent Hospital, Toledo, OH; University Institute of Diagnostic and Interventional Neuroradiology (J.K.), Inselspital, Bern University Hospital, University of Bern, Switzerland; Neurology and Neurosurgery (R.G.N.), University of Pittsburgh Medical Center, PA; Neurology (J.L.S.), University of California in Los Angeles; Neurology (L.L.), The Second Affiliated Hospital of Harbin Medical University, China; Neurology (H.S.), Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou; Neurology (Q.Y.), Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University, Chongqinq, China; and Department of Neurology (T.N.N.), Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, MA.
与医疗管理相比,内血管血栓切除术 (EVT) 显著改善了中风患者的大血管封闭 (LVO) 和大缺血核心的功能结果. EVT不会增加症状性内出血的风险,提供更安全的治疗选择.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 公共卫生 公共卫生
背景情况:
- 带有大缺血核心的大血管封闭性 (LVO) 卒中是一个重大的临床挑战.
- 对这些患者来说,内血管血栓切除术 (EVT) 越来越多地被考虑,但与医疗管理 (MM) 相比,其疗效和安全性需要进行严格的评估.
结论:
- 对于LVO中风和大缺血核心的患者来说,EVT是一种有效的治疗方法,导致比MM更好的功能结果.
- 这种手术与症状性内出血的风险相似,使其成为一种有利的治疗选择.
- 目前正在进行的RCT预计将为管理这一关键患者群体提供进一步的见解.
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