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机械血栓切除术超过24小时从最后一个已知的合病变:一个多中心队列研究
Aaron Rodriguez-Calienes1,2, Ameer E Hassan3, James E Siegler4,5
1Department of Neurology, University of Iowa Hospitals and Clinics, Iowa City, IA, USA.
概括
机械血栓切除术 (MT) 可能有利于出现超过24小时后的宫并列病变 (TLs) 的患者. 这项研究没有发现TL的早期和晚期MT之间的结果有显著差异.
科学领域:
- 神经学 神经学
- 干预性神经辐射学
- 脑卒中医学 脑卒中医学
背景情况:
- 机械血栓切除术 (MT) 越来越多地用于大血管封闭.
- 它对从上次已知病例 (LKW) 开始的24小时以后的子宫合病变 (TLs) 的疗效尚未得到充分证实.
- 本研究研究了在延长时间窗口中TLs的MT.
研究的目的:
- 为了评估MT的安全性和有效性,用于从LKW24小时以后的急性宫并列病变 (TLs).
- 为了比较MT在延长时间窗口与标准0-24小时窗口的结果.
主要方法:
- 对前部循环TL患者的多中心注册表 (2015年1月至2020年12月) 的次分析.
- 24小时以后的MT与0-24小时内的MT的比较.
- 结果包括功能独立,再输,NIHSS变化,出血和死亡率.
- 治疗权重的逆概率 (IPTW) 用于组平衡.
主要成果:
- 33名患者接受MT超过24小时;556人接受MT在0-24小时内.
- 在IPTW后,功能独立性没有显著差异 (OR0.51;P=.108).
- 完全转血 (OR 1.35;P=.464),症状性内出血 (OR 1.96;P=.429),以及死亡率在各组之间相似.
结论:
- 机械血栓切除术 (MT) 似乎是安全有效的,对于出现超过24小时LKW的宫并列病变 (TLs) 的患者.
- 这些发现支持在这个延长的时间窗口中考虑MT.
- 建议进行进一步的前性研究来证实这些结果.
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