在经过机械血栓切除术的大缺血核心患者的基线临床和神经放射学预测结果:一项回顾性多中心研究
Andrea M Alexandre1, Mauro Monforte2, Valerio Brunetti2
1Interventional Neuroradiology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
概括
较年轻的年龄和较低的NIHSS分数预测机械血栓切除术后更好的结果对于大型缺血核心. 然而,皮层区域的早期缺血变化与中风患者的不良结果有关.
科学领域:
- 神经学 神经学
- 干预性神经放射学 干预性神经放射学
- 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,即使已经建立了大型缺血核心,MT也具有好处.
- 在这个特定的患者群体中预测结果仍然至关重要.
研究的目的:
- 确定前部循环LVO和大缺血核心的患者临床结果的基线预测因素 (阿尔伯塔中风计划早期CT得分 [ASPECTS] ≤ 5),接受MT.
- 分析特定ASPECTS区域对功能恢复的影响.
主要方法:
- 来自16个中风中心的408名患者的回顾性分析,这些患者接受了LVO的MT,ASPECTS ≤5.
- 收集基线临床和神经放射学数据,包括ASPECTS区域参与.
- 后勤回归和随机森林分析,以确定90天修改的兰金尺度 (mRS) 评分0-2.0的预测因素.
主要成果:
- 较低的年龄和较低的美国国立卫生研究院中风量表 (NIHSS) 分数与有利的90天mRS分数 (0-2) 有关.
- 参与M2或M4方面地区独立预测不利结果.
- 随机森林分析证实年龄和NIHSS是关键预测因素,皮质区域参与 (M1,M2,M4,M5) 对结果产生负面影响.
结论:
- 年龄和基线NIHSS得分是MT后在患有大缺血核心的患者中功能性结果的显著预测因素.
- 在皮层区域 (M1,M2,M4,M5) 的早期缺血变化会对结果产生负面影响.
- 这些发现有助于在精选中风患者中选择患者和预测MT的结果.
相关概念视频
Imaging Studies for Cardiovascular System IV: CMRI
541
Cardiovascular magnetic resonance imaging, or CMRI, is a non-invasive diagnostic test that employs a magnetic field and radiofrequency waves to create precise images of the heart and arteries. It provides comprehensive information about cardiac anatomy, function, perfusion, and tissue characterization without ionizing radiation.IndicationsCMRI diagnoses various heart conditions, including tissue damage from heart attacks, ischemic heart disease, myocarditis, aortic issues (tears, aneurysms,...
541
Acute Coronary Syndrome III: Diagnostic Studies
495
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
495
Aneurysm II: Clinical Manifestations and Diagnostic Studies
589
Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
589
Imaging Studies VII: Vascular Imaging
558
DefinitionRenal angiography, also known as renal arteriography, is an imaging technique used to obtain a comprehensive view of blood flow and the vascular structure of blood vessels in the kidneys and surrounding areas.PurposeRenal angiography detects blood vessel abnormalities in the kidneys, such as aneurysms, stenosis, thrombosis, vascular tumors, and renal artery stenosis. It evaluates kidney function and guides interventional treatments like angioplasty or stent placement.Pre-Procedure...
558
Ischemic Stroke l: Introduction
44
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
44
Ischemic Stroke ll: Pathophysiology
54
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
54


