在机械血栓切除术后急性阶段使用口服抗凝剂治疗的结果
Koichiro Shindo1,2, Tatsuya Ogino1,2, Kenji Kamiyama1
1Department of Neurosurgery, Nakamura Memorial Hospital, Sapporo, Hokkaido, Japan.
Journal of neuroendovascular therapy
|July 28, 2023
概括
口服抗凝剂 (OAC) 是安全有效的,用于预防机械血栓切除术 (MT) 后复发性脑梗塞. 在MT之后的急性阶段开始OAC可以减少中风复发的风险,而不会增加出血并发症.
科学领域:
- 神经学 神经学
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 机械血栓切除术 (MT) 改善了急性脑梗塞的治疗结果.
- 在MT后的急性阶段,口服抗凝剂 (OAC) 的使用正在增加.
- 在MT后启动OAC的最佳时间尚不清楚,这构成了临床挑战.
研究的目的:
- 报告我们机构在MT之后使用OAC的情况.
- 评估OACs在预防MT后早期并发症方面的安全性和有效性.
- 为了比较直接口服抗凝剂 (DOAC) 和华法林 (Wf) 之间的结果.
主要方法:
- 对64名接受MT治疗的前循环栓塞的患者进行了回顾性分析.
- 患者接受了DOAC (n=28) 或华法林 (n=36) 作为二次预防.
- 评估的结果包括内出血和30天内复发性脑梗塞.
主要成果:
- 在DOAC组中没有观察到任何症状出血事件,而在华法林组中为2.8%.
- 在30天内复发的脑梗塞发生在0%的DOAC患者和2.8%的华法林患者中.
- 在DOAC组中,新的或恶化的出血转变率较低.
结论:
- 在机械血栓切除术后的急性阶段,可以安全地使用口服抗凝剂.
- OACs在预防MT后复发性脑梗塞方面表现出有效性.
- 在这种患者群体中,早期启动OAC似乎是对二次预防的可行策略.
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