什么是挑战性凝块? :来自CLOTS 7.0峰会的DELPHI共识声明
Johanna M Ospel1, Mahmood Mirza2, Frédéric Clarençon3
1Departments of Diagnostic Imaging and Clinical Neurosciences, Foothills Medical Centre, University of Calgary, 1403 29th St. NW, T2N2T9, Calgary, AB, Canada. johannaospel@gmail.com.
Clinical neuroradiology
|June 7, 2023
概括
在急性中风机械血栓切除术期间,很难识别具有挑战性的血块. 专家们确定了具有挑战性的血块的8个特征,包括白色,化,性和粘附性,有助于更好地治疗患者.
科学领域:
- 神经学 神经学
- 干预性放射学 干预性放射学
- 凝块研究 凝块研究
背景情况:
- 机械血栓切除术是急性中风的关键治疗方法.
- 由于缺乏专家共识,预测和定义对内血管方法具有挑战性的凝块仍然很困难.
- 这项研究旨在通过专家意见来定义具有挑战性的血块,并确定指示性特征.
研究的目的:
- 在急性中风中建立具有挑战性的凝块的共识定义.
- 为了识别特定的凝块和患者特征,表明难以重建的凝块.
- 为了提高在内血管治疗 (EVT) 之前识别具有挑战性的闭塞的准确性.
主要方法:
- 一种经过修改的DELPHI技术被用于中风血栓切除和凝块研究专家.
- 这项研究涉及三轮询问,从开放式问题开始,到闭式问题.
- 共识被定义为≥50%的小组成员之间的共识,包括在确定性上评分≥3分之4的特征.
主要成果:
- 在30个问题中有16个问题达成共识.
- 八个特征被认定为共识和高确定性:白色血栓,化血栓 (历史学和成像),硬血栓,粘性/粘附性血栓,硬血栓,难以通过的血栓和抗拉血栓.
- 大多数专家同意在2-3次失败后切换内血管治疗技术.
结论:
- 建立了具有挑战性的凝块的共识定义,突出了8个不同的特征.
- 已识别的特征为先验识别具有挑战性的遮提供了基础.
- 需要进一步的务实研究来验证这些发现,并提高EVT结果的预测准确性.
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