血栓切除术与或没有静脉注射血栓缓解剂在基底动脉封闭的基础动脉
Benjamin Maïer1,2,3,4, Stephanos Finitsis5, Mikael Mazighi3,4,6,7
1Neurology Department, Hôpital Saint-Joseph, Paris, France.
Annals of neurology
|June 14, 2023
概括
单独用于基底动脉阻塞 (BAO) 中风的内血管治疗 (EVT) 显示出与静脉血栓溶解 (IVT) 的EVT类似的结果. 这表明单独使用EVT可能是BAO中风患者的可行的治疗选择.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
背景情况:
- 内血管疗法 (EVT) 是有效的基础动脉阻塞 (BAO) 的中风.
- 在BAO中风中,静脉血栓溶解 (IVT) 在EVT之前的作用仍然不清楚,因为在关键试验中IVT使用率很低.
研究的目的:
- 为了比较单独EVT与IVT加EVT在BAO中风患者中的疗效和安全性.
主要方法:
- 一项前性,观察性,多中心研究分析了来自内血管治疗在缺血性中风注册表 (2015-2021) 的数据.
- 倾向性得分匹配用于比较仅用EVT治疗的患者与IVT + EVT治疗的患者.
- 结果包括90天后良好的功能结果 (mRS 0-3) 和功能独立性 (mRS 0-2),以及症状性内出血和全因死亡率.
主要成果:
- 在倾向分数匹配后,分析了243名患者 (仅有134名EVT,109名IVT+EVT).
- 两组之间在良好的功能结果 (aOR=1.27,p=0.45) 或功能独立性 (aOR=1.50,p=0.21) 上没有发现显著差异.
- 在单独使用EVT和IVT+EVT组之间,症状性内出血率和全因死亡率也相似.
结论:
- 在BAO中风患者中,单独的EVT似乎与IVT+EVT相比,提供了类似的神经恢复和安全性.
- 由于本研究的观察性质和样本大小,需要进一步的研究来证实这些发现.
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