在中风患者中机械血栓切除术的结果极大心脏梗塞核心
Eyad Almallouhi1, Sara Zandpazandi2, Mohammad Anadani2
1Neuro Interventional Surgery, Sarasota Memorial Hospital, Sarasota, FL, USA.
Journal of neurointerventional surgery
|December 2, 2023
概括
机械血栓切除术 (MT) 可能有利于选择患有大血管封闭 (LVO) 和极大心脏梗塞核心 (阿尔伯塔中风计划早期CT分数0-2) 的患者. 在这项回顾性研究中,成功的再通道化和年轻的年龄与有利的结果有关.
科学领域:
- 神经学 神经学
- 干预神经病学 干预神经病学
- 脑卒中医学 脑卒中医学
背景情况:
- 机械血栓切除术 (MT) 越来越多地用于大血管封闭 (LVO) 中风.
- 最近的试验表明,即使有大型心脏病核心,也会有好处.
- 这项研究侧重于LVO患者的极大心脏病发作 (阿尔伯塔中风计划早期CT评分0-2).
研究的目的:
- 为了评估LVO患者的MT的结果,ASPECT 0-2.
- 确定与这种患者群体中有利结果相关的因素.
主要方法:
- 对中风血栓切除和动脉瘤注册 (STAR) 的回顾性分析.
- 包括患有LVO (ICA或M1 MCA) 和ASPECT 0-2.0 的患者.
- 良好的结果被定义为修改的兰金尺度 (mRS) 0-3在90天.
- 成功的再通道化定义为在脑缺血中修改的血栓溶解 (mTICI) 评分≥2B.
主要成果:
- 58名具有ASPECT 0-2的患者接受了MT.
- 死亡率为41.4%的死亡率.
- 31%的人取得了良好的结果 (90天的mRS 0-3).
- 年龄较大 (≥70) 与不良结果相关 (mRS 5-6).
- 有利结果的独立预测因素包括年轻的年龄,入院时NIH中风量表较低,以及成功的再通道化 (mTICI ≥2B).
结论:
- 在一个精选的LVO患者群体中,MT可能对具有极大的心脏病核心 (ASPECT 0-2) 的LVO患者有益.
- 选择患者并实现成功的再通道化对于优化治疗结果至关重要.
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