带有编织内膜桥装置的血栓栓塞事件:发生率,预测因素和管理
Fernanda Rodriguez-Erazú1,2, Jonathan Cortese1,3, Cristian Mihalea1
1Department of Interventional Neuroradiology, Bicêtre University Hospital, Paris , France.
Neurosurgery
|September 20, 2023
概括
血栓栓塞栓事件 (TEE) 发生在13%的Woven EndoBridge (WEB) 设备治疗宽动脉瘤的患者中. 破裂动脉瘤和设备更换预测TEEs,但管理产生最小的发病率.
科学领域:
- 神经外科 神经外科
- 干预性神经放射学 干预性神经放射学
- 血管外科 血管外科
背景情况:
- 编织EndoBridge (WEB) 设备越来越多地用于宽动脉瘤.
- 虽然有效,但已报告有显著的血栓栓塞事件 (TEE) 发生率.
- 预测因素和TEE的管理需要进一步阐明.
研究的目的:
- 为了评估TEE的发病率和管理在WEB设备治疗后.
- 在破裂和未破裂的内动脉瘤中确定TEE的预测因素.
- 评估 WEB 器件栓塞的临床结果和安全性.
主要方法:
- 用WEB设备治疗动脉瘤的单中心数据库的回顾性审查 (2012年7月 - 2022年5月).
- 分析包括手术内和延迟的TEE.
- 进行了单变量和多变量分析,以确定TEE预测因素.
主要成果:
- 总共治疗了266例动脉瘤;13% (35/266) 经历了TEE,其中8.7%是手术内.
- 带有临床后果的症状TEE发生在2.6% (7/266) 的患者中,没有TEE相关的死亡率.
- 破裂动脉瘤 (aOR=2.74) 和WEB设备更换 (aOR=2.61) 是TEE的独立预测因素.
结论:
- 破裂动脉瘤和手术内替换器件是TEE的重要预测因素.
- 仔细选择 WEB 设备对于最佳治疗结果至关重要.
- 有效的TEE医疗管理,包括使用蒂罗菲班,可以实现最小的发病率和无死亡率,支持WEB技术的安全性.
相关概念视频
01:29Venous 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
01:27Pulmonary Embolism III: Nursing Management
15
A pulmonary embolism occurs when a thrombus, amniotic fluid, tumor tissue, fat, or air embolus blocks one or more pulmonary arteries. Effective nursing management and patient education are crucial for improving outcomes and preventing recurrence.Nursing management starts with obtaining a comprehensive patient history, particularly noting any history of deep vein thrombosis (DVT). Assess for clinical manifestations, including dyspnea, chest pain, crackles, heart murmurs, and signs of right-sided...
15
01:29Pulmonary 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
01:30Venous Thrombosis IV: Nursing Management
14
Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
14
01:29Endocarditis IV: Nursing Management
16
Infective endocarditis (IE) is a chronic infection of the heart's endocardium, primarily affecting the heart valves. A detailed nursing assessment for a patient with IE involves collecting subjective and objective data to ensure an accurate diagnosis and timely intervention.Subjective DataThe nurse gathers information about the patient's symptoms and complaints during the subjective assessment. Patients with infective endocarditis often report non-specific symptoms that can mimic other...
16
01:23Peripheral Artery Disease V: Postoperative Nursing Management
12
During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
12