血管内治疗后与出血转化相关的因素,尽管早期的再通道化
Antonio Ciacciarelli1, Agostino Tessitore2, Giulia Fiume3
1Department of Translational and Precision Medicine, Sapienza University of Rome, Italy; U.O.S.D. Stroke Unit, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
Journal of the neurological sciences
|September 5, 2023
概括
在中风后7.67小时后,出血转化 (HT) 风险增加. 尽管进行了机械血栓切除术,但动脉内膜介质厚度和中性粒细胞与淋巴细胞的比率等新型因素预测了HT.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 心脏病学 心脏病学
背景情况:
- 机械血栓切除术改善了急性缺血性中风的结果.
- 血流转化 (HT) 是一种并发症,尽管成功进行了再通道化,但仍可能发生.
- 确定预测HT的因素对于优化治疗策略至关重要.
研究的目的:
- 在接受机械血栓切除术治疗的急性缺血性中风患者中,确定与出血转化 (HT) 相关的新型因素.
- 为了确定开始到重建的时间和HT风险之间的关系.
- 评估动脉内膜介质厚度 (CIMT) 和中性粒细胞与淋巴细胞比率 (NLR) 的预测值,用于HT.
主要方法:
- 追溯分析874名大型血管封闭症患者,这些患者接受了机械血栓切除术.
- 数据收集包括患者特征,风险因素,放射学发现和治疗细节.
- 使用非对比CTCT评估HT发病率,其次要结局包括症状性脑内出血和脑膜性血瘤.
主要成果:
- 在包括的472名患者中,44.7%的患者经历过HT.
- 与增加的HT风险相关的因素包括更长的发病时间,正常/轻度CIMT,ASPECT-MRI<6和更高的NLR.
- 在7.67小时的时间内,从发病到重建,HT风险超过50%.
结论:
- 包括CIMT和NLR在内的新型因素,在经过机械血栓切除术的急性缺血性中风患者中独立预测HT.
- 从开始到重新调节的时间是一个关键因素,在7.67小时后风险显著增加.
- 这些发现有助于风险分层和HT后血栓切除术的管理.
相关概念视频
Venous Thrombosis III: Interprofessional Care
10
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
10
Venous Thrombosis I: Introduction
12
Venous thrombosis, the most common disorder of the veins, involves the formation of a thrombus or blood clot associated with vein inflammation. It can be classified as either superficial vein thrombosis or deep vein thrombosis.Superficial Vein Thrombosis: This involves the formation of a thrombus in a superficial vein, usually the greater or lesser saphenous vein. Though less severe than deep vein thrombosis (DVT), SVT can lead to complications if untreated.Deep Vein Thrombosis (DVT): This...
12
Clot Retraction and Fibrinolysis
6.4K
After a fibrin clot is formed, the next step is clot retraction, a vital process facilitated by platelet contractile proteins, such as actin and myosin. These proteins pull the fibrin strands closer together and condense the clot. This action reduces the size of the clot, creating a smaller, denser structure that effectively seals off the damaged vessel. Clot retraction consolidates the clot and helps with wound healing by bringing the edges of the damaged blood vessel closer together.
6.4K
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
10
Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
10


