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在24小时以后的内血管治疗前部循环大血管封闭或急性缺血性中风的狭窄:一个回顾性研究
An Wen1,2, Wen-Feng Cao1,2, Chao Zhao3
1Department of Neurology, Jiangxi Provincial People's Hospital (The First Affiliated Hospital of Nanchang Medical College), Nanchang, Jiangxi, China.
Frontiers in neurology
|December 21, 2023
概括
在24小时以上的急性缺血性中风内血管治疗 (EVT) 显示,在选定的患者中,功能独立性得到改善,死亡率降低. 需要进一步的研究来证实这些对中风治疗有前途的结果.
科学领域:
- 神经学 神经学
- 干预心脏病学 干预心脏病学
- 血管外科 血管外科
背景情况:
- 由于大血管封闭/缩小,急性缺血性中风需要及时干预.
- 内血管治疗 (EVT) 是这种情况的主要治疗方法.
- 评估超出标准24小时窗口的EVT的结果至关重要.
研究的目的:
- 为了评估EVT对急性缺血性中风 (AIS) 的临床和安全结果,前循环大血管封闭/缩小症 (ACLVO/S) 患者在症状出现后24小时以上接受治疗.
- 为了比较在24小时内接受EVT的患者与24小时后接受治疗的患者之间的结果.
主要方法:
- 在2019年1月至2022年2月期间接受EVT的连续AIS-ACLVO/S患者的回顾性分析.
- 患者被分为两组:EVT<24小时和EVT>24小时.
- 评估的结果包括成功的再输血 (mTICI ≥2b),90天修改的兰金尺度 (mRS) 评分,内出血 (ICH),症状性ICH (sICH) 和死亡率.
主要成果:
- 总共分析了239名患者 (214名在EVT<24小时组,25名在EVT>24小时组).
- 与EVT<24小时组相比,EVT>24小时组的90天功能独立率显著更高 (mRS ≤2;80%对39.7%) 和90天死亡率更低 (0%对24.8%),与EVT<24小时组相比.
- 在两组之间,成功的再输血,ICH和SICH的比率相似.
结论:
- 超过24小时的内血管治疗,特别是通过多式MR查选择的患者,与有利的功能独立性和低死亡率有关.
- 这些发现表明,在选择的AIS患者中,延长治疗窗口的潜在好处.
- 需要更大规模的随机研究来验证这些结果并完善治疗指南.
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