在血管期破裂动脉瘤的卷轴:基于倾向性得分分析的安全性和有效性
Takao Koiso1, Tetsu Satow1, Eika Hamano1
1Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.
Journal of neuroendovascular therapy
|July 28, 2023
概括
血管内线圈对于出现3天以后的动脉瘤下arachnoid出血 (SAH) 患者是安全有效的. 这种治疗甚至在血管的情况下也是可行的,表现出与早期干预相似的结果.
科学领域:
- 神经外科 神经外科
- 干预性放射学 干预性放射学
- 脑血管疾病 脑血管疾病
背景情况:
- 动脉瘤下关节出血 (SAH) 是一种危急的情况,通常需要及时干预.
- 内血管治疗的最佳时间,特别是在3天后出现的患者中,仍然是研究领域.
研究的目的:
- 评估干预性放射学 (IVR) 对于神经瘤下关节出血 (SAH) 的安全性和有效性,当治疗在症状出现后3天后开始时.
主要方法:
- 一项回顾性研究比较了71名患者,这些患者接受了SAH的内血管卷积.
- 患者被分为两组:早期治疗 (3天内) 和延迟治疗 (4-14天).
- 采用了与案例匹配的研究设计,以尽量减少选择偏差.
主要成果:
- 延迟治疗组 (D组) 患病率较高的世界神经外科协会 (WFNS) 1-3级和手术前血管.
- 尽管存在这些差异,但治疗过程中的并发症,症状性血管,延迟性脑梗塞或在出院时修改的兰金尺度 (mRS) 分数在两组之间没有显著差异.
- 倾向性得分匹配证实,早期和延迟治疗队列之间没有显著的结果差异.
结论:
- 在SAH发作后3天后出现的患者中,对于破裂动脉瘤,可以安全地进行内血管卷积.
- 即使存在血管,治疗也是可行的,结果与早期干预措施相似.
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