在患有活跃恶性瘤的患者中治疗急性缺血性中风:来自综合性中风中心的见解
Woon Hyung Chae1, Annika Vössing1, Yan Li2
1Department of Neurology and Center for Translational Neuro- and Behavioral Sciences, University Hospital Essen, Essen, Germany.
Therapeutic advances in neurological disorders
|November 3, 2023
概括
像IVT和EVT这样的再通道治疗对于患有活跃癌症的急性缺血性中风 (AIS) 患者是安全的. 这些疗法没有增加出血风险,癌症患者和对照患者的神经系统改善相似.
科学领域:
- 神经学 神经学
- 在瘤学瘤学.
- 血管医学 血管医学
背景情况:
- 急性缺血性中风 (AIS) 在癌症患者中很常见,但对再通道治疗的安全性数据仍然有限.
- 现有的指导方针对于在这种高风险人群中使用再注射治疗缺乏共识.
研究的目的:
- 评估急性再通道化疗法的安全性和有效性,在有活跃恶性瘤的AIS患者中.
- 为了调查血栓溶解和/或内血管治疗后发生重大出血事件的特定风险.
主要方法:
- 在2017年1月至2020年12月期间接受治疗的1016名AIS患者的回顾性分析.
- 在患有活跃恶性瘤的患者和对照组之间比较出血风险 (症状性内出血,全身出血) 和神经改善.
- 专注于使用rtPA (IVT) 和/或内血管治疗 (EVT) 的静脉血栓溶解.
主要成果:
- 79名具有活跃恶性瘤的AIS患者中没有发生与中风治疗相关的全身出血.
- 症状性内出血 (SICH) 的发病率在两组之间是可比的 (7.6%与4.7%),混因素解释了差异.
- 在患有和没有活跃恶性瘤的患者中,神经学改善率相似.
结论:
- 急性再通道化疗法是AIS患者活跃恶性瘤的安全治疗选择.
- 在这个患者队列中,IVT和/或EVT不会增加系统性或内出血的风险.
- 患有AIS的瘤学患者可以从及时的再输血疗法中受益,而不会产生严重的安全问题.
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