血栓减弱梯度可以预测成功的第一通道再通道化后的Stentriever血栓切除术
Hari Kishore Kamepalli1, Santhosh Kumar Kannath1, P N Sylaja1
1Neurointervention Center, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India.
World neurosurgery
|November 4, 2023
概括
计算机断层扫描血管造影 (CTA) 血栓增强特征预测成功的支架恢复器血栓切除术. 通过血栓衰减梯度 (TAG) 测量的动态对比动力学准确地预测了急性中风患者的第一通复通.
科学领域:
- 神经成像是一种神经成像.
- 干预神经病学 干预神经病学
- 脑卒中成像 脑卒中成像
背景情况:
- 计算机断层扫描血管造影 (CTA) 对于评估急性大血管封闭性中风至关重要.
- 在CTA上的血栓特征可以预测治疗结果.
- 在支架检索器血栓切除术后的第一通道再通道是关键的疗效终点.
研究的目的:
- 调查是否通过多相CTA评估的血栓内的动态对比动力学可以预测第一通道再通道化.
- 为了将血栓减弱梯度 (TAG) 与成功的单通血栓切除术结果相关联.
主要方法:
- 对69名急性中风患者的回顾性分析,这些患者接受了多相CTA和支架恢复器血栓切除术.
- 在动脉,静脉和延迟阶段计算血栓通透度和血栓衰减梯度 (TAG).
- TAG与首次通道再通道的相关性 (修改后的脑性缺血治疗得分≥2b).
主要成果:
- 在47%的患者中,成功的第一通道再通道发生.
- 在动脉平坦 (P=0.01) 和静脉动脉 (P=0.02) 阶段,TAG显示了成功和失败的第一通组之间的显著差异.
- 在动脉平坦 (9.2 HU) 和静脉动脉 (4.2 HU) 阶段的TAG切线值预测了在验证队列中的74%准确度的第一通效应.
结论:
- 来自多相CTA的血栓减弱梯度 (TAG) 是第一通道再通道化的重要预测因素.
- 多相CTA对比动力学提供了有价值的洞察力,在支架检索器血栓切除过程中对血栓的行为.
- TAG分析可以帮助预测血栓切除术的成功,并指导治疗决策.
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