在用管道栓塞装置治疗内动脉瘤后,动脉瘤闭塞的预测因素
Mohamed M Salem1, MirHojjat Khorasanizadeh1, Felix Nwajei1
1Neurosurgical Service, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Acta neurochirurgica
|August 24, 2023
概括
高血压可能改善管道栓塞装置 (PED) 治疗后的大脑动脉瘤封闭. 这项研究发现,高血压患者倾向于出现更高的动脉瘤完全堵塞的几率,这表明高凝血能力的潜在好处.
科学领域:
- 神经内血管外科手术是一种神经内血管手术.
- 脑血管疾病 脑血管疾病
- 医疗器械技术 医疗器械技术
背景情况:
- 管道栓塞装置 (PED) 通过流量转移,血栓形成和内皮质化来促进动脉瘤封闭.
- 高血压 (HTN) 与高凝血和内皮功能障碍有关,可能影响治疗结果.
- 在PED治疗后成功阻塞动脉瘤的预测因素,特别是HTN的作用,仍未得到充分研究.
研究的目的:
- 为了调查PED治疗后动脉瘤封闭的预测因素.
- 具体评估高血压对动脉瘤堵塞率在流量转移后的影响.
主要方法:
- 用PED治疗的大脑动脉瘤的回顾性审查 (2013-2019).
- 通过药物史或平均静缩血压>130 mmHg定义的高血压.
- 多变量后勤回归分析了HTN对闭塞的影响,控制年龄,吸烟,动脉瘤大小,形态,位置和结合的分支.
主要成果:
- 分析包括294名患者的331个动脉瘤 (平均年龄59岁,79.9%为女性).
- 55%的患者是高血压患者.
- 高血压患者显示完全闭塞的几率较高的趋势 (OR=2.05;p=0.052),而年龄较大和合并的分支减少了闭塞的几率.
结论:
- 高血压与PED治疗后增加完全动脉瘤封闭的趋势有关.
- 潜在的机制包括HTN诱导的高凝性和改变的内皮/细胞外矩阵调节.
- 需要进一步的研究来澄清这些发现的临床影响.
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