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选择性动脉支架符合指南中定义的质量标准

Fee Keil¹, Simon Stahn², Sarah Christina Reitz³

¹Neuroradiology, Hospital of the Goethe University Frankfurt Institute of Neuroradiology, Frankfurt am Main, Germany.

RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin

|November 14, 2023

概括

选择性动脉支架 (CAS) 符合严格的质量指导方针,在有症状的患者中,并发症率低至0.8%. 紧急CAS程序的并发症率明显较高,突出显示需要进行单独的质量评估.

科学领域:

血管外科血管外科
干预心脏病学干预心脏病学
神经学神经学

背景情况:

目前的指导方针推 carotid endarterectomy (CEA),而不是选择性心动脉支架 (CAS),作为二线治疗.
比较CAS和CEA的随机试验已经有十多年了.
在区分选修和紧急CAS干预方面存在质量保证挑战.

研究的目的:

在经验丰富的中心评估神经控制的CAS结果.
为了确定可选CAS是否符合严格的质量标准.
为了比较急性缺血性中风的选择性和紧急CAS干预之间的并发症率.

主要方法:

分析了在2012年1月1日至2022年7月之间针对急性中风的141项选择性CAS程序 (症状和无症状狭窄症) 和158项紧急CAS程序.
对并发症率进行神经学控制的数据收集.
评估与CAS相关的并发症和临床结果 (NIHSS进展).

主要成果:

对症状性狭窄症的选择性CAS具有0.8%的低中风/死亡率.
对于无症状狭窄症的CAS,没有观察到并发症.
与选择性CAS (p < 0.006) 相比,紧急CAS程序的并发症率显著更高 (7.8%).

结论:

选择性CAS可以符合严格的S3指南2022质量标准,即使有有限的指示和病例数.
紧急CAS干预具有显著更高的并发症率,需要单独考虑质量保证.
由于不同的条件和结果,可选和紧急CAS不能直接比较.

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