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血栓切除术有或没有计算机断层扫描输液成像用于扩展时间窗口中的大血管封闭性中风:随机临床试验的元分析

Zheng Zhan¹, Feng Gu¹, Yi Ji¹

¹Department of Neurosurgery and Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Frontiers in neurology

|September 5, 2023

概括

无对比CT (NCCT) 与CT血管造影 (CTA) 在大血管封闭 (LVO) 中的机械血栓切除术中与计算机断层扫描输液 (CTP) 一样有效. 这种方法显著减少了治疗时间,改善了患者的治疗结果.

科学领域:

神经学神经学
放射学放射学是一门学科.
干预心脏病学干预心脏病学

背景情况:

机械血栓切除术是大血管封闭 (LVO) 中风的关键治疗方法.
计算机断层扫描输液 (CTP) 用于在延长的时间窗口中评估治疗资格,但耗时且昂贵.
无对比CT (NCCT) 与CT血管造影 (CTA) 提供了一个替代的成像策略.

研究的目的:

为了比较CTP与NCCT±CTA在经过机械血栓切除术的LVO中风患者的预后影响.
在延长的时间窗口中评估不同成像模式的效率和有效性.

主要方法:

随机对照试验 (RCT) 的系统审查和元分析,比较CTP和NCCT±CTA策略.
结果指标包括修改的兰金尺度得分,再注射率和不良事件.
分析使用了标准化的平均差异,比率和相对风险,具有95%的置信区间.

主要成果:

在CTP和NCCT±CTA组之间,在90天的功能结果,再输率或不良事件中没有发现显著差异.
从最后一个已知的时间到动脉穿刺的时间在NCCT ± CTA组中显着更短.
影响90天功能结果的因素包括年龄,ASPECTS,NIHSS得分和糖尿病.

结论:

在6-24小时内,NCCT±CTA是CTP的可行的替代方案,用于评估LVO中风患者的机械血栓切除术.
使用NCCT±CTA可以显著减少治疗延迟,潜在地改善患者管理.
这项研究强调了成像选择在优化中风治疗工作流程中的重要性.

关键词:

在 CTP CTP 中使用.这是NCCT的NCCT.大血管封闭性中风这是一个元分析.预后预后预后

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