针对新出现的大血管封闭的内血管治疗指南的重点更新:基底动脉封闭患者
Jeremy Josef Heit1, Neeraj Chaudhary2, Justin R Mascitelli3
1Departments of Radiology and Neurosurgery, Stanford University Medical Center, Stanford, California, USA.
Journal of neurointerventional surgery
|April 26, 2024
概括
内血管治疗 (EVT) 现在适用于12小时内基底动脉阻塞中风. 此外,EVT的长达24小时也是合理的,对于某些患者来说,可能会考虑超出这个时间框架.
科学领域:
- 神经科学是一个神经科学.
- 干预神经病学 干预神经病学
- 血管神经学 血管神经学
背景情况:
- 内血管治疗 (EVT) 显著改善了前部循环出现的大血管封闭 (ELVO) 卒中的结果.
- 最近的试验表明,EVT对基底动脉封闭有好处,这促使该指南更新.
研究的目的:
- 为后部循环中EVT提供有针对性的建议.大血管封闭 (LVO) 卒中.
- 根据基础动脉封闭治疗的新证据,更新现有的SNIS指南.
主要方法:
- 一个结构化的文献综述和对EVT研究的分析,用于后部循环LVO中风.
- 由SNIS标准和指南委员会在专家共识下制定的建议.
主要成果:
- 在12小时内急性基底动脉或脊椎动脉封闭 (I类,B-R级) 时, EVT 适用.
- EVT在12-24小时内是合理的 (IIa类,B-R级),并且可以考虑超过24小时 (IIb类,C-EO级).
- 对于18岁以下或89岁以上的患者,可以根据具体情况 (IIb类,C-EO级) 考虑进行EVT.
结论:
- 对于ELVO中风的EVT指示现在包括基底动脉封闭.
- 需要进一步的试验来证实在更广泛的患者群体和长期结果中EVT的疗效和安全性.
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