在急性缺血性中风中,血栓切除术后DSA的脑循环时间与出血变化相关
Jianyu Liu1, Yuanyuan Gu2, Da-Zhong Zhang3
1Department of Interventional Radiology, Jiangsu Taizhou People's Hospital, Hailing District, Taizhou, Jiangsu, China.
Acta neurochirurgica
|February 5, 2024
概括
在中风血栓切除术后,脑循环时间 (CCT) 缩短与出血转化 (HT) 的风险更高有关. 这一发现有助于预测中风的结果,并指导治疗决策.
科学领域:
- 神经学 神经学
- 放射学 放射学是一门学科.
- 血管医学 血管医学
背景情况:
- 出血转化 (HT) 是急性缺血性中风 (AIS) 治疗后的一个重大并发症.
- 评估HT的风险因素对于优化内血管治疗后患者的治疗结果至关重要.
研究的目的:
- 为了确定通过数字减去血管学测量的大脑循环时间 (CCT) 和AIS患者中HT的发生之间的关联.
- 确定CCT作为一种潜在的成像生物标志物,用于在机械血栓切除术后预测HT.
主要方法:
- 对AIS患有大血管封闭症的患者进行回顾性分析,接受了血栓切除术和成功的再通道化.
- 大脑循环时间 (CCT) 计算来自数字减去血管学,定义为从内动脉吸管可视化到动脉阶段结束的间隔.
- 用于评估CCT和HT之间的独立关联的物流回归和接收器运行特征 (ROC) 曲线分析.
主要成果:
- 在224名患者中,86名 (38.4%) 患有HT.
- 与没有HT的患者相比,HT患者的CCT显著缩短 (P<0.05).
- 多变量分析证实CCT是HT的独立预测因子 (调整后OR,0.170;P<0.001),最佳切断值为1.72s (AUC0.846).
结论:
- 短暂的血栓切除术后的CCT独立地与急性缺血性中风中出血转变的风险增加有关.
- 在机械血栓切除术后,CCT可以作为一个有价值的成像标志物来预测HT风险.
- 这些发现可以为临床决策和患者风险分层提供信息.
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