在高风险病例中,动脉支架的并发症和结果
So Ozaki1, Taisuke Akimoto2, Yu Iida3
1Department of Neurosurgery, Yokohama City University Medical Center, 4-57 Urafune, Minami, Yokohama 2320024, Japan.
概括
三重抗血栓治疗增加了动脉支架 (CAS) 的并发症. 在中风后28天以上等待CAS可能会对预后产生负面影响,这表明对高风险患者推迟治疗存在潜在风险.
科学领域:
- 干预神经病学 干预神经病学
- 血管外科 血管外科
- 脑卒中医学 脑卒中医学
背景情况:
- 动脉支架 (CAS) 是选择高风险患者的选择.
- 在中风发作后CAS的最佳时间仍在争论中,特别是在高危人群中.
研究的目的:
- 为了确定影响高风险患者进行CAS的并发症和结果的因素.
- 分析相对于中风发作的治疗时间对CAS结果的影响.
主要方法:
- 以CAS治疗的152名患者的回顾性分析 (2018年1月至2022年3月).
- 评估风险因素,包括患者背景,程序风险 (曲,化,斑块),狭窄特征和治疗时间.
- 多变量分析以确定并发症和不良结果的独立预测因子 (修改的兰金尺度恶化).
主要成果:
- 70.4%的患者有CAS风险因素;30.0%出现了症状并发症.
- 14.0%的高风险患者有90天修改的兰金度量评分恶化.
- 三重抗血栓治疗,在7天内支架,在中风后28天后支架独立地与并发症有关.
结论:
- 三重抗血栓治疗是CAS中术后并发症的重要危险因素.
- 延迟CAS (28天后) 可能会对预后产生不利影响.
- 在中风患者中等待CAS超过一个月可能会构成风险,需要进一步调查.
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