在新兴的M1中脑动脉封闭中发生的血栓迁移
Slaven Pikija1, Monika Killer-Oberpfalzer2, Johannes A R Pfaff3
1Department of Neurology, University Hospital Salzburg, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria.
Clinical neurology and neurosurgery
|February 4, 2024
概括
血栓迁移发生在M1中脑动脉封闭的近四分之一的患者中,通常与高血治疗有关. 然而,这种迁移通常不会影响内血管血栓切除术后的临床或放射性结果.
科学领域:
- 神经学 神经学
- 干预性神经辐射学
- 血管神经学 血管神经学
背景情况:
- 血栓迁移 (TM) 在内血管封闭中观察到,特别是在高血药物后.
- TM对再输血成功和临床结果的影响仍在调查中.
- 了解M1中脑动脉 (MCA) 阻塞中的TM对于治疗优化至关重要.
研究的目的:
- 调查M1 MCA封闭患者中血栓迁移的发生率和结果.
- 为了确定血栓迁移,高高位素的使用和临床/放射学结果之间的关系.
- 在这个患者队列中描述与血栓迁移相关的结果谱.
主要方法:
- 在2015-2020年间,对463名患有M1 MCA封闭症的患者进行了内血管血栓切除术 (EVT) 的回顾性分析.
- 在EVT前CT/MR血管造影和EVT后成像测量血栓近位位置,以评估生长,稳定性,迁移或分辨率.
- 多变量回归分析以确定与TM相关的因素及其对结果的影响.
主要成果:
- 血栓迁移发生在22.8% (106/463) 的患者中.
- 阿尔特等的使用和从初始成像到血管造影的较长间隔与TM有显著的关联.
- 良好的临床结果 (修改的兰金尺度0-2) 与TM状态无关.
结论:
- 血栓迁移是M1 MCA封闭的一个常见事件,影响了近四分之一的患者.
- 阿尔特普拉斯治疗是血栓迁移的重要预测因子.
- 在M1MCA封闭中TM似乎对放射学和临床结果基本上没有影响.
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